Acute Lymphocytic Leukemia - Complications

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Infections. Some children may be more vulnerable to infections after completing chemotherapy, although the immune system tends to improve over time. Studies 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.

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 suggest 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.

Recognizing this risk and getting psychologic support early is important and helpful. Nevertheless, in one 2002 study, young survivors reported satisfaction with life, a sense of purpose, and an ability to cope because of their experiences with cancer. A 2004 study confirmed these results, reporting that 81% of adult survivors of childhood ALL had a positive self-concept.

Effects on Caregivers

One study found that parents who take care of children with ALL develop more symptoms of post-traumatic stress disorder than their children.

Review Date: 01/16/2007
Reviewed By: Harvey Simon, MD, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital