Long-Term Risk of Hospitalization for Somatic Diseases among Survivors of Childhood Acute Lymphoblastic Leukemia

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  • Gitte Vrelits Sørensen
  • Vanna Albieri
  • Anna Sällfors Holmqvist
  • Friederike Erdmann
  • Hanna Mogensen
  • Mats Talbäck
  • Marianne Ifversen
  • Timothy Lee Lash
  • Maria Feychting
  • Schmiegelow, K.
  • Mats Marshall Heyman
  • Jeanette Falck Winther
  • Henrik Hasle

Background: Survivors of childhood acute lymphoblastic leukemia (ALL) may be at increased long-term risk of hospitalization for somatic diseases. However, large population-based cohort studies with risk estimates for survivors successfully cured without experiencing a relapse or requiring hematopoietic stem cell transplantation (HSCT) are lacking. Methods: Danish and Swedish patients diagnosed with ALL before age 20 years in 1982-2008 were identified in the national cancer registries. Five-year survivors and matched population comparisons without childhood cancer were followed for hospitalization for 120 somatic disease categories in the national hospital registries from 5 years postdiagnosis until 2017, and disease-specific hospitalization rate ratios (RR) were calculated. The mean cumulative count method was used to estimate the mean number of multiple and recurrent disease-specific hospitalizations per individual. Results: A total of 2024 5-year survivors and 9797 population comparisons were included. The overall hospitalization rate was more than twice as high compared with comparisons (RR = 2.30, 95% confidence interval [CI] = 2.09 to 2.52). At 30 years postdiagnosis, the mean cumulative hospitalization count was 1.69 (95% CI = 1.47 to 1.90) per survivor and 0.80 (95% CI = 0.73 to 0.86) per comparison. In the subcohort without relapse or HSCT (n = 1709), the RR was 1.41 (95% CI = 1.27 to 1.58). Conclusions: Survivors of childhood ALL were at increased long-term risk for disease-specific hospitalizations; however, in survivors without relapse or HSCT, the rate was only modestly higher than in population comparisons without a childhood cancer. The absolute mean numbers of multiple and recurrent hospitalizations were generally low.

OriginalsprogEngelsk
Artikelnummerpkac029
TidsskriftJNCI Cancer Spectrum
Vol/bind6
Udgave nummer2
Antal sider10
ISSN2515-5091
DOI
StatusUdgivet - 2022

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© 2022 The Author(s). Published by Oxford University Press.

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