Late outcomes of adult survivors of childhood non-Hodgkin lymphoma: A report from the St. Jude Lifetime Cohort Study

Pediatr Blood Cancer. 2017 Jun;64(6):10.1002/pbc.26338. doi: 10.1002/pbc.26338. Epub 2016 Nov 15.

Abstract

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.

Keywords: chronic health conditions; late effects; neurocognitive; non-Hodgkin lymphoma; survivorship.

Publication types

  • Clinical Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Attention*
  • Child
  • Child, Preschool
  • Chronic Disease
  • Female
  • Follow-Up Studies
  • Humans
  • Hypertension* / epidemiology
  • Hypertension* / etiology
  • Hypertension* / physiopathology
  • Infant
  • Lymphoma, Non-Hodgkin* / mortality
  • Lymphoma, Non-Hodgkin* / physiopathology
  • Lymphoma, Non-Hodgkin* / therapy
  • Male
  • Memory*
  • Neurocognitive Disorders* / epidemiology
  • Neurocognitive Disorders* / etiology
  • Neurocognitive Disorders* / physiopathology
  • Obesity* / epidemiology
  • Obesity* / etiology
  • Obesity* / physiopathology
  • Risk Factors
  • Survivors*