Health knowledge about symptoms of heart attack and stroke in adult survivors of childhood acute lymphoblastic leukemia

Ann Epidemiol. 2007 Oct;17(10):778-81. doi: 10.1016/j.annepidem.2007.05.004. Epub 2007 Jul 27.


Purpose: Children with acute lymphoblastic leukemia (ALL), the most common pediatric malignancy, have a 5-year survival rate of better than 80%. Long-term survivors of childhood ALL, however, carry an elevated risk of early mortality from cardiac events and stroke and a disproportionately high prevalence of dyslipidemia and obesity, presumably as an adverse effect of treatment.

Methods: As part of a clinical follow-up study of 70 young adult survivors of childhood ALL, we evaluated the degree to which this high-risk group differed in knowledge about symptoms of heart attack and stroke from that of a population-based comparison group frequency-matched by age, sex, and body mass index. Questions from the Behavioral Risk Factor Surveillance System were used to assess health knowledge.

Results: Survivors of ALL scored considerably worse on symptom knowledge than did their population counterparts. The strongest association was observed for chest pain as a symptom of heart attack: ALL survivors were 14-fold more likely than the comparison group to answer the question incorrectly. Seventy-seven percent of survivors failed to identify pain in the jaw, neck, or back as a heart attack symptom.

Conclusions: These results indicate an important gap in knowledge and underscore the need for health education among survivors of childhood leukemia that includes information about symptoms of myocardial infarction and stroke.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Behavioral Risk Factor Surveillance System
  • Child
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Male
  • Middle Aged
  • Minnesota
  • Myocardial Infarction / diagnosis*
  • Myocardial Infarction / physiopathology
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma*
  • Stroke / diagnosis*
  • Stroke / physiopathology
  • Survivors*