Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Rajthevi, Bangkok, 10400, Thailand.
Int J Hematol. 2010 Jun;91(5):850-4. doi: 10.1007/s12185-010-0594-9. Epub 2010 May 20.
Survivors of childhood acute lymphoblastic leukemia (ALL) are at risk of long-term late effects. Therefore, systematic screenings of the late complications are essential. The objective of this study was to determine the prevalence of late effects of Thai children and adolescents after completion of ALL therapy. We performed a cross-sectional study for evaluation of the late effects in ALL survivors who came for follow-up at 10 pediatric oncology centers in Thailand. We evaluated the treatment-related late complications of children and adolescents who had finished ALL treatment for at least 2 years. Demographic data, treatment modalities, and late effects were recorded and analyzed. There were 258 survivors with a median age of 12.2 years (range 3.6-23.3 years). The median follow-up time was 7.2 years (range 2-17.5 years). Forty-seven percent (122 cases) suffered from at least one late effect. Overweight/obesity was the most common late effect. Radiation of central nervous system was a significant risk factor for overweight/obesity (OR 1.97, 95% CI 1.02-3.81) and educational problems (OR 4.3, 95% CI 1.32-14.02). Our data have demonstrated a significant prevalence of late effects after childhood ALL therapy. A long-term follow-up program for survivors of childhood cancer is therefore needed in our country.
儿童急性淋巴细胞白血病（ALL）幸存者存在长期迟发性并发症的风险。因此，系统筛查迟发性并发症至关重要。本研究旨在确定泰国儿童和青少年在完成 ALL 治疗后迟发性并发症的患病率。我们对 10 个泰国儿科肿瘤中心接受随访的 ALL 幸存者进行了一项横断面研究，以评估 ALL 幸存者的迟发性影响。我们评估了至少完成 2 年 ALL 治疗的儿童和青少年的治疗相关迟发性并发症。记录并分析了人口统计学数据、治疗方式和迟发性影响。共有 258 名幸存者，中位年龄为 12.2 岁（范围 3.6-23.3 岁）。中位随访时间为 7.2 年（范围 2-17.5 年）。47%（122 例）至少有一种迟发性影响。超重/肥胖是最常见的迟发性影响。中枢神经系统放疗是超重/肥胖（OR 1.97，95%CI 1.02-3.81）和教育问题（OR 4.3，95%CI 1.32-14.02）的显著危险因素。我们的数据表明，儿童 ALL 治疗后迟发性并发症的患病率很高。因此，我们国家需要为儿童癌症幸存者建立长期的随访计划。
