Medical Health Encyclopedia

Obesity. Children treated for ALL are at higher risk for obesity, possibly because the treatments trigger an earlier than normal occurrence in childhood weight gain. Corticosteroids, drugs used in treatments, also increase appetite, which contributes to the problem. One study indicated, however, that lifestyle factors, such as adopting a pattern of reduced physical activity during treatment, plays the major role in this complication.

Impaired Mental and Neurologic Functioning. Cranial radiation and drugs used in chemotherapy, especially specific corticosteroids and intrathecal treatments may impair mental functioning and cause neurologic problems, such as movement problems. Advances in cranial radiation may reduce the neurologic and mental risks from this treatment, but it can occur with many other treatments as well. A 2001 report suggested that methylphenidate (Ritalin) may improve mental performance in children.

Infections. Some children may be more vulnerable to infections after completing chemotherapy, although the immune system tends to improve over time. Studies now suggest that young survivors of leukemia have an increased risk for measles, mumps, and rubella (MMR), even if they have been previously vaccinated. Children, then, may need reimmunization.

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Impaired Physical Growth. Cranial radiation can result in impaired growth.

Infertility. Chemotherapy, cranial radiation, or both can impair fertility in male and female patients.

Secondary Cancer. Rarely secondary cancers, most often leukemia (generally acute myeloid leukemia), can later develop.

Psychologic and Mental Consequences

Studies are finding that survivors of childhood leukemia tend to have more psychological problems, including stress, depression, anger, and confusion, than their physically healthy siblings. As adults, they are also more likely to be unemployed or working part time. Risk for mood psychological problems may vary by treatment. A 2003 study showed that patients who received high-dose CNS radiation and methotrexate therapy had an increased risk of mood disturbances compared to those who did not receive radiation.