What are the long-term effects in adult survivors of childhood non-Hodgkin lymphoma?

This study explored the long-term health outcomes of adult survivors of childhood non-Hodgkin lymphoma (NHL) patients. The authors determined that adult survivors have a high rate of chronic health conditions.

Long-term survival of childhood NHL has increased due to improvements in treatment options. An understanding of the long-term effects of cancer treatments has altered what therapies are used, and at what intensity. Some studies, though, have noted that adult survivors of childhood NHL may experience poorer health compared to the general population. An understanding of the long-term risks of NHL treatment is needed. This could help with early detection of issues and long-term management.

This study explored the incidence of chronic health conditions and other long-term effects of childhood NHL treatments. 200 adult survivors of childhood NHL were examined. The average age of the patient at diagnosis was 10 years. The average age of the patient in the current study was 34 years (a range from 20 to 58 years).

65% of patients were overweight or obese. 37% had elevated fasting glucose (a blood test that indicates prediabetes or diabetes). 35% reported high cholesterol. 25% reported high blood pressure.

Radiation to the abdomen increased the risk of high cholesterol by 60% and the risk of high fasting glucose by 90%. Cranial (head) radiation increased the risk of obesity by 20%. Obese patients had 2 times the risk of high fasting glucose. Females had a 30% decrease in the risk of overweight or obesity compared to men.

Radiation affecting the reproductive organs was associated with 31.5 times the risk of these organs failing to function. Neck or thyroid irradiation was associated with a 5-fold increase in the risk of hypothyroidism.

Radiation was associated with 6 times the expected rate of second cancers compared to the general population. 49% of patients experienced impairments in executive functioning. This refers to behaviors such as attention, focus, planning, and memory. 30% reported attention problems, and 35% reported memory problems. Being of a non-white race increased the risk of memory/attention problems. Radiation delivered to the head was associated with a 3.3-fold increased risk of depression. Females were 3 times more likely than males to consider suicide.

Obesity was associated with decreases in physical function. Cardiac (heart) radiation was associated with 2.5 times the risk of decreased aerobic function (ability to take in oxygen).

This study reported a high rate of chronic health conditions in adult survivors of childhood NHL. 

It is important to remember that treatments have changed (like the use of radiation) over the years. Also, this study is reporting on associations, not proof of causation.