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Late outcomes of adult survivors of childhood non‐Hodgkin lymphoma: A report from the St. Jude Lifetime Cohort Study
Author(s) -
Ehrhardt Matthew J.,
Sandlund John T.,
Zhang Nan,
Liu Wei,
Ness Kirsten K.,
Bhakta Nickhill,
Chemaitilly Wassim,
Krull Kevin R.,
Brinkman Tara M.,
Crom Deborah B.,
Kun Larry,
Kaste Sue C.,
Armstrong Gregory T.,
Green Daniel M.,
Srivastava Kumar,
Robison Leslie L.,
Hudson Melissa M.,
Mulrooney Daniel A.
Publication year - 2017
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.26338
Subject(s) - medicine , common terminology criteria for adverse events , neurocognitive , cohort , percentile , pediatrics , quality of life (healthcare) , adverse effect , physical therapy , cognition , psychiatry , statistics , mathematics , nursing
Background Survivors of childhood non‐Hodgkin lymphoma (NHL) are at increased risk for chronic health conditions. The objective of this study was to characterize health conditions, neurocognitive function, and physical performance among a clinically evaluated cohort of 200 childhood NHL survivors. Method Chronic health and neurocognitive conditions were graded as per a modified version of the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) and impaired physical function defined as performance < 10th percentile of normative data. Multivariable regression was used to investigate associations between sociodemographic characteristics, therapeutic exposures, and outcomes. Results Survivors were a median age of 10 years (range 1–19) at diagnosis and 34 years (range 20–58) at evaluation. Eighty‐eight (44%) received radiation, 46 (23%) cranial radiation, and 69 (35%) high‐dose methotrexate. Most prevalent CTCAE Grades 3–4 (severe life‐threatening) conditions were obesity (35%), hypertension (9%), and impairment of executive function (13%), attention (9%), and memory (4%). Many had impaired strength (48%), flexibility (39%), muscular endurance (36%), and mobility (36%). Demographic and treatment‐related factors were associated with the development of individual chronic diseases and functional deficits. Conclusions Clinical evaluation identified a high prevalence of chronic health conditions, neurocognitive deficits, and performance limitations in childhood NHL survivors.