Research
Print page Print page
Switch language
Rigshospitalet - a part of Copenhagen University Hospital
Published

Late mortality among survivors of childhood acute lymphoblastic leukemia diagnosed during 1971-2008 in Denmark, Finland, and Sweden: A population-based cohort study

Research output: Contribution to journalJournal articleResearchpeer-review

DOI

  1. Epithelioid hemangioendothelioma in children: The European Pediatric Soft Tissue Sarcoma Study Group experience

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. The clinical impact of observer variability in lung nodule classification in children with Wilms tumour

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Socioeconomic position and maintenance therapy in children with acute lymphoblastic leukemia: A national cohort study

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Characteristics of white blood cell count in acute lymphoblastic leukemia: A COST LEGEND phenotype-genotype study

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Changes in body mass index during treatment of childhood acute lymphoblastic leukemia with the Nordic ALL2008 protocol

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. End-of-life communication: a nationwide study of bereaved parents' perceptions

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. EXABS-103-ALL Advances in ALL Diagnosis and Treatment -The NOPHO Experience

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Cancer-related Mutations with Local or Long-range Effects on an Allosteric Loop of p53

    Research output: Contribution to journalJournal articleResearchpeer-review

  • Gitte V Sørensen
  • Federica Belmonte
  • Friederike Erdmann
  • Hanna Mogensen
  • Vanna Albieri
  • Anna S Holmqvist
  • Laura Madanat-Harjuoja
  • Mats Talbäck
  • Mats M Heyman
  • Nea Malila
  • Maria Feychting
  • Kjeld Schmiegelow
  • Jeanette F Winther
  • Henrik Hasle
View graph of relations

OBJECTIVE: Investigate all-cause and cause-specific late mortality after childhood acute lymphoblastic leukemia (ALL) in a population-based Nordic cohort.

METHODS: From the cancer registries of Denmark, Finland, and Sweden, we identified 3765 five-year survivors of ALL, diagnosed before age 20 during 1971-2008. For each survivor, up to five matched comparison subjects were randomly selected from the general population (n = 18,323). Causes of death were classified as relapse related, health related, and external. Late mortality was evaluated by cumulative incidences of death from 5-year survival date. Mortality hazard ratios (HR) were evaluated with Cox proportional models.

RESULTS: Among the survivors, 315 deaths occurred during a median follow-up of 16 years from 5-year survival date (range 0-42). The majority were attributable to relapse (n = 224), followed by second neoplasm (n = 45). Cumulative incidence of all-cause late mortality at 15 years from diagnosis decreased gradually over treatment decades, from 14.4% (95% confidence interval [CI]: 11.6-17.2) for survivors diagnosed during 1971-1981, to 2.5% (95% CI: 1.3-3.7) for those diagnosed during 2002-2008. This was mainly attributable to a reduction in relapse-related deaths decreasing from 13.4% (95% CI: 10.7-16.1) for survivors diagnosed during 1971-1981 to 1.9% (95% CI: 0.9-2.8) for those diagnosed during 2002-2008. Health-related late mortality was low and did not change substantially across treatment decades. Compared to comparison subjects, all-cause mortality HR was 40 (95% CI: 26-61) 5-9 years from diagnosis, and 4.4 (95% CI: 3.4-5.6) ≥10 years from diagnosis.

CONCLUSIONS: Survivors of ALL have higher late mortality than population comparison subjects. Among the survivors, there was a temporal reduction in risk of death from relapse, without increments in health-related death.

Original languageEnglish
Article numbere29356
JournalPediatric Blood & Cancer
Volume69
Issue number1
Pages (from-to)e29356
ISSN1545-5009
DOIs
Publication statusPublished - Jan 2022

Bibliographical note

© 2021 Wiley Periodicals LLC.

    Research areas

  • Adult, Cancer Survivors/statistics & numerical data, Cohort Studies, Denmark/epidemiology, Finland/epidemiology, Humans, Overtreatment, Precursor Cell Lymphoblastic Leukemia-Lymphoma/mortality, Sweden/epidemiology, Young Adult

ID: 78120081