Late effects in survivors of infant leukemia

W. Leung, M. Hudson, Y. Zhu, G. K. Rivera, R. C. Ribeiro, J. T. Sandlund, L. C. Bowman, W. E. Evans, L. Kun, C. H. Pui

Research output: Contribution to journalArticlepeer-review

74 Scopus citations


Little is known about the incidence of and risk factor for late effects of infant leukemia. We evaluated 19 children with acute lymphoblastic leukemia and 15 with acute myeloid leukemia who were diagnosed at age 12 months or younger and have survived for more than 5 years after the diagnosis (median length of follow-up, 13 years; range, 5.7-29 years). Ten patients received chemotherapy alone (group A), 17 received chemotherapy and CNS-directed radiation therapy (CRT) (group B), and seven received chemotherapy, CRT and bone marrow transplantation (group C). The most frequently observed late sequelae included problems in growth (66% of survivors), learning (50%), hypothyroidism (15%), and pubertal development (12%). Cataract, cardiac and hearing abnormalities occurred in 6% of patients. Only eight patients (24%) survive without late effects. In comparison to patients in group A, patients in group B and C had a higher incidence of having at least one late complication (P=0.009), a greater decrease in height Z score at 5 years after diagnosis (P=0.023), and a higher incidence of academic difficulties (P=0.004). The estimated odds of academic difficulties increased by 18% (P=0.032) for each month younger in age at the time of CRT. These results indicate that late sequelae are common in longterm survivors of infant leukemia and are often related to CRT and the patient's age at the time of CRT.

Original languageEnglish (US)
Pages (from-to)1185-1190
Number of pages6
Issue number7
StatePublished - 2000


  • Infant ALL
  • Infant AML
  • Infant leukemia
  • Late effects

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research


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