Adverse effects of treatment in childhood acute lymphoblastic leukemia: general overview and implications for long-term cardiac health

Expert Rev Hematol. 2011 Apr;4(2):185-97. doi: 10.1586/ehm.11.8.


Survival of childhood acute lymphoblastic leukemia (ALL) is one of the greatest medical success stories of the last four decades. Unfortunately, childhood ALL survivors experience medical late effects that increase their risk of morbidity and premature death, often due to heart and vascular disease. Research has helped elucidate the mechanisms and trajectory of direct damage to the heart from treatment exposure, particularly to anthracyclines, and has also contributed knowledge on the influences of related chronic conditions, such as obesity and insulin resistance on heart health in these survivors. This article summarizes the key issues associated with early morbidity and mortality from cardiac-related disease in childhood ALL survivors and suggests directions for interventions to improve long-term outcomes.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Antibiotics, Antineoplastic / adverse effects*
  • Antibiotics, Antineoplastic / therapeutic use
  • Child
  • Heart Diseases / etiology
  • Human Growth Hormone / deficiency
  • Human Growth Hormone / metabolism
  • Humans
  • Metabolic Diseases / complications
  • Obesity / complications
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / complications
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / mortality
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy*
  • Stem Cell Transplantation


  • Antibiotics, Antineoplastic
  • Human Growth Hormone