[Long-term care of young adults surviving childhood cancer - where do we go?].

METHODS

Between January 1990 and November 2006, 65 consecutive childhood cancer survivors entered a prospective follow-up study to evaluate the frequency and severity of tumor- and/or therapy-related long-term sequelae. Their median age at diagnosis was 9.7 years, median actual age is 25.1 years, and median duration of follow-up is 14.8 years.

RESULTS

Nine patients (13.9%) were completely free from late effects, whereas 31/65 patients (47.6%) had only minimal late effects without need of medical support and 25/65 patients (38.5%) had severe late effects requiring long-term medical care. The most frequent late effects were endocrine deficits, musculosceletal problems, neurologic problems, chronic hepatitis and hearing loss. Currently, a network of local adult care providers is being established in order to enable a smooth and competent referral from pediatric hemato-oncology to adult medicine.

CONCLUSIONS

Two thirds of former childhood cancer patients are able to return to everyday life without any impairment. However, one third is suffering from considerable morbidity requiring long-term medical care. Transition models from pediatric hemato-oncology to adult health care providers are urgently needed.