Abstract
There has been remarkable progress in the therapeutic outcome of acute leukemia, notably childhood acute lymphoblastic leukemia (ALL). This is the result of a well-integrated systemic therapy (remission induction, consolidation, maintenance and central nervous system prophylaxis) with a combination of multiple drugs. In Japan, a nationwide survey of long-term (≥5 years) survivors of childhood acute leukemia was begun in 1970; only 35 patients were involved in the survey throughout the country. Today, over two-thirds of children with ALL can be cured. With these improvements in therapeutic outcome, however, a problem has emerged. Some children apparently cured of the disease are afflicted with delayed adverse sequelae of anti-leukemic therapy.Potential posttreatment complications for children with acute leukemia include : (1) impairment of growth and development, (2) CNS disturbances including neurologic, psychologic and mental manifestations, (3) dysfunction of other organs and structures, such as the hypothalamo-pituitary gland, testis, ovaries, bone, heart, liver, pancreas, kidney, etc, (4) oncogenesis, (5) social problems. The purpose of this paper was to describe the late effects of childhood acute leukemia, with special reference to the current status of long-term survivors of the disease.
