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Rebecca Olin, MD, MS


Long-Term Psychosocial and Neurocognitive Impact of Childhood AML

By: Celeste L. Dixon
Posted: Monday, September 28, 2020

Based on an analysis of data from the Childhood Cancer Survivor Study by Christopher Recklitis, PhD, MPH, of Harvard Medical School and Dana-Farber Cancer Institute, Boston, and colleagues, long-term survivors of childhood acute myeloid leukemia (AML) were found to be at greater risk for neurocognitive and psychosocial impairment, compared with siblings who never had cancer. No greater risk of late psychosocial effects was associated with having had a bone marrow transplant versus chemotherapy alone, however, according to the work published in the Journal of the National Cancer Institute.

Included in the study were 482 survivors who were diagnosed with AML at a median age of 8 years (range, 0–20 years). They responded to questions at a median age of 30 years (range, 18–49 years). The median age at an evaluation of 3,190 sibling controls was 32 years (range, 18–58 years). The two groups were compared in terms of emotional distress, neurocognitive problems, social attainment, and health-related quality of life.

The AML survivors were significantly “more likely than siblings to report impairment in overall emotional (relative risk = 2.19), neurocognitive (relative risk = 2.03), and physical quality-of-life (relative risk = 2.71) outcomes,” reported Dr. Recklitis and co-investigators. Additionally, they were at increased risk for lower education (relative risk = 1.15), unemployment (relative risk = 1.41), lower-income (relative risk = 1.39), and not being married or partnered (relative risk = 1.33).

A total of 44% of the cancer survivors in the study reported impairment in at least one domain. “As a whole, 35% of pediatric cancer survivors have been reported to have neurocognitive impairments,” stated the authors, “suggesting that acute myeloid leukemia survivors may benefit from increased monitoring for neurocognitive impairment even compared to other diagnostic groups.”

Disclosure: The study authors reported no conflicts of interest.

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