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Meeting Challenges in the Long-Term Care of Children, Adolescents, and Young Adults with Acute Lymphoblastic Leukemia

  • Acute Lymphocytic Leukemias (M Keng and FE Chaer)
  • Published:
Current Hematologic Malignancy Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

To discuss the long-term view of treating and following pediatric, adolescent, and young adult patients with acute lymphoblastic leukemia (ALL) — with review of what can be done to prevent, monitor for, and treat complications of therapy.

Recent Findings

Pediatric, adolescent, and young adult oncology patients, including those with ALL, are living longer with higher overall survival rates as treatments and supportive care for these patients continue to improve. These patients are burdened by the risk of significant health and quality of life consequences as a result of their treatment.. For these patients, the late effects of treatment can be life-threatening, such as secondary cancers or cardiotoxicity, or life-altering with respect to quality of life.

Summary

The goal of this paper is to review the current literature, research, and surveillance guidelines regarding the late effects of ALL therapy, to outline what can be done to mitigate the toxic effects of oncology treatment, and to extend life expectancy and improve quality of life for our patients. We review risk factors and interventions available to prevent and treat cardiovascular disease, secondary malignancies, endocrine complications (obesity, osteoporosis, infertility, and premature menopause), cognitive effects, and effects on functioning and mortality.

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Funding

Michael Douvas receives funding support from Pfizer to run a multi-institution clinical trial for patients with acute lymphoblastic leukemia.

Lara Riegler has no external funding.

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Authors and Affiliations

  1. University of Virginia Health System, 6011 West Complex, University of Virginia Hospital, Charlottesville, VA, 22908-0716, USA

    Michael G. Douvas

  2. University of Virginia Health System, Charlottesville, VA, USA

    Lara L. Riegler

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  1. Michael G. Douvas
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  2. Lara L. Riegler
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Correspondence to Michael G. Douvas.

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Michael Douvas and Lara Riegler declare no potential conflicts of interest.

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This article contains no studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Acute Lymphocytic Leukemias

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Douvas, M.G., Riegler, L.L. Meeting Challenges in the Long-Term Care of Children, Adolescents, and Young Adults with Acute Lymphoblastic Leukemia. Curr Hematol Malig Rep 17, 15–24 (2022). https://doi.org/10.1007/s11899-021-00657-x

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  • DOI: https://doi.org/10.1007/s11899-021-00657-x

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