Screening and interventional strategies for the late effects and toxicities of hematological malignancy treatments in pediatric survivors

ABSTRACT

Introduction

Advancements in pediatric cancer treatment have increased patient survival rates; however, childhood cancer survivors may face long-term health challenges due to treatment-related effects on organs. Regular post-treatment surveillance and early intervention are crucial for improving the survivors’ quality of life and long-term health outcomes. The present paper highlights the significance of late effects in childhood cancer survivors, particularly those with hematologic malignancies, stressing the importance of a vigilant follow-up approach to ensure better overall well-being.

Areas covered

This article provides an overview of the treatment history of childhood leukemia and lymphoma as well as outlines the emerging late effects of treatments. We discuss the various types of these complications and their corresponding risk factors.

Expert opinion

Standardizing survivorship care in pediatric cancer aims to improve patient well-being by optimizing their health outcomes and quality of life. This involves early identification and intervention of late effects, requiring collaboration among specialists, nurses, and advocates, and emphasizing data sharing and international cooperation.

KEYWORDS:

• Hematological malignancy
• late effects
• late mortality
• secondary malignant neoplasms
• standardized long-term follow-up
• pediatric cancer survivors

Article highlights

• Treatment of pediatric hematologic malignancies has significantly advanced through multiphase protocols, risk assessment, and targeted therapies, focusing on improving survival rates and reducing the risk of late effects.

• Surveillance for late effects in different organs after treatment is tailored based on treatment intensity, emphasizing the need for a collaborative approach between survivors and healthcare providers.

• Advancements in genetic analysis have identified leukemia-predisposing genes in some pediatric cancer patients, necessitating tailored monitoring and screening such as brain MRI, mammograms, and colonoscopies for effective disease management and timely intervention.

• The aim of standardizing survivorship care for pediatric cancer survivors is to enhance their well-being and quality of life by promoting early detection and intervention for late effects through multidisciplinary collaboration and international data sharing.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgments

The authors would like to thank Enago (https://www.enago.jp) for their English language review.

Additional information

Funding

This paper was funded by a Japan Society for the Promotion of Science grant from the Ministry of Education, Culture, Sports, Science and Technology (no. 20K08750).