Long-term effects on growth, development, and metabolism of ALL treatment in childhood

ABSTRACTIntroduction: One aim of the long-term care in survivors from acute lymphoblastic leukemia (ALL) during childhood is to avoid or limit complications caused by aggressive therapeutic strategies.Areas covered: ALL survivors are a heterogeneous group according to therapeutic protocols. In the last decades, cranial radiotherapy (cRT) has been largely replaced by intrathecal chemotherapy (CT) with a reduction of endocrine sequelae. Published studies are generally difficult to be interpreted because patients were treated according to different risk-adapted protocols and results are conflicting. We perform this review on endocrine long-term effects in childhood ALL survivors focusing on studies published in the last decades. Articles were selected using the following terms (Mesh terms): ‘acute lymphoblastic leukemia’ AND ‘survivors’ AND ‘childhood’ AND ‘growth/puberty/fertility/obesity/metabolic syndrome/bone’.Expert commentary: Most childhood ALL survivors treated with CT alone attain normal height and ...