Late mortality and morbidity among long-term leukemia survivors with Down syndrome : A nationwide population-based cohort study
(2018) In Pediatric Blood & Cancer 65(9).- Abstract
Background: Late health consequences of treatment for childhood leukemia are well documented. Although individuals with Down syndrome (DS) have a substantially increased risk of leukemia, information on late effects in this group is almost nonexistent. The aim of this study was to evaluate the mortality and morbidity among 5-year leukemia survivors with DS. Procedure: We compared 5-year leukemia survivors with leukemia-free individuals with DS. All individuals born with DS in Denmark between 1960 and 2007 and in Sweden between 1973 and 2009 were included. Long-term morbidity was estimated by comparing hospitalization rates between survivors and leukemia-free individuals. Results: In total, we found 6,705 individuals with DS, 84 of whom... (More)
Background: Late health consequences of treatment for childhood leukemia are well documented. Although individuals with Down syndrome (DS) have a substantially increased risk of leukemia, information on late effects in this group is almost nonexistent. The aim of this study was to evaluate the mortality and morbidity among 5-year leukemia survivors with DS. Procedure: We compared 5-year leukemia survivors with leukemia-free individuals with DS. All individuals born with DS in Denmark between 1960 and 2007 and in Sweden between 1973 and 2009 were included. Long-term morbidity was estimated by comparing hospitalization rates between survivors and leukemia-free individuals. Results: In total, we found 6,705 individuals with DS, 84 of whom were 5-year survivors of leukemia. Survivors had a higher risk of death (hazard ratio [HR] 5.9; 95% confidence interval [CI]: 2.7–13) compared with leukemia-free individuals. All deaths (n = 7) among 5-year leukemia survivors were due to relapse. Survivors had a higher hospitalization rate (HR 4.4; 95% CI: 3.1–6.2). However, most of these hospitalizations were due to relapse. Censoring individuals who either had a relapse or were being treated for a relapse more than 5 years from the initial diagnosis (n = 9) attenuated the association (HR 1.4; 95% CI: 1.0–2.1). Conclusion: In this study, we found that relapse was the main reason for death and hospitalization among leukemia survivors with DS, and not late effects. These results are reassuring for individuals treated for DS associated with leukemia and their parents.
(Less)
- author
- Vonasek, Julia ; Asdahl, Peter ; Heyman, Mats ; Källén, Karin LU and Hasle, Henrik
- organization
- publishing date
- 2018-09-01
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Down syndrome, late effects, leukemia, morbidity, mortality
- in
- Pediatric Blood & Cancer
- volume
- 65
- issue
- 9
- article number
- e27249
- publisher
- John Wiley & Sons Inc.
- external identifiers
-
- pmid:29797653
- scopus:85050376571
- ISSN
- 1545-5009
- DOI
- 10.1002/pbc.27249
- language
- English
- LU publication?
- yes
- id
- c696564e-cad9-459c-ad72-65bbc4ccecf3
- date added to LUP
- 2018-08-15 11:47:37
- date last changed
- 2024-04-01 09:08:06
@article{c696564e-cad9-459c-ad72-65bbc4ccecf3,
abstract = {{<p>Background: Late health consequences of treatment for childhood leukemia are well documented. Although individuals with Down syndrome (DS) have a substantially increased risk of leukemia, information on late effects in this group is almost nonexistent. The aim of this study was to evaluate the mortality and morbidity among 5-year leukemia survivors with DS. Procedure: We compared 5-year leukemia survivors with leukemia-free individuals with DS. All individuals born with DS in Denmark between 1960 and 2007 and in Sweden between 1973 and 2009 were included. Long-term morbidity was estimated by comparing hospitalization rates between survivors and leukemia-free individuals. Results: In total, we found 6,705 individuals with DS, 84 of whom were 5-year survivors of leukemia. Survivors had a higher risk of death (hazard ratio [HR] 5.9; 95% confidence interval [CI]: 2.7–13) compared with leukemia-free individuals. All deaths (n = 7) among 5-year leukemia survivors were due to relapse. Survivors had a higher hospitalization rate (HR 4.4; 95% CI: 3.1–6.2). However, most of these hospitalizations were due to relapse. Censoring individuals who either had a relapse or were being treated for a relapse more than 5 years from the initial diagnosis (n = 9) attenuated the association (HR 1.4; 95% CI: 1.0–2.1). Conclusion: In this study, we found that relapse was the main reason for death and hospitalization among leukemia survivors with DS, and not late effects. These results are reassuring for individuals treated for DS associated with leukemia and their parents.</p>}},
author = {{Vonasek, Julia and Asdahl, Peter and Heyman, Mats and Källén, Karin and Hasle, Henrik}},
issn = {{1545-5009}},
keywords = {{Down syndrome; late effects; leukemia; morbidity; mortality}},
language = {{eng}},
month = {{09}},
number = {{9}},
publisher = {{John Wiley & Sons Inc.}},
series = {{Pediatric Blood & Cancer}},
title = {{Late mortality and morbidity among long-term leukemia survivors with Down syndrome : A nationwide population-based cohort study}},
url = {{http://dx.doi.org/10.1002/pbc.27249}},
doi = {{10.1002/pbc.27249}},
volume = {{65}},
year = {{2018}},
}