Childhood Leukemia Overview

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After Treatment TOPICS

Late and long-term effects of treatment for childhood leukemia

Just as the treatment of childhood leukemia requires a very special approach, so does the care and follow-up after treatment. The earlier the problems are found, the more likely it is they can be treated effectively.

Childhood leukemia survivors are at risk, to some degree, for several possible late effects of their treatment. This risk depends on a number of factors, such as the type of leukemia, the type and doses of treatment, and the child’s age at time of treatment. It’s important to discuss what these possible effects might be with your child’s medical team so you know what to watch for and report to the doctor.

Second cancers: Children who have been treated for leukemia have a higher risk of getting other cancers later in life.

Heart and lung problems: Certain chemo drugs or radiation therapy to the chest can sometimes cause heart or lung problems later in life.

Learning problems: Treatment that includes radiation therapy to the brain or some types of chemotherapy may affect learning ability in some children.

Growth and development: Some treatments may affect a child’s growth, so they may end up a bit shorter as adults. This is especially true after stem cell transplants. This can be helped by treatment with growth hormone, if needed.

Fertility issues: Cancer treatment might also affect sexual development and the ability to have children later in life. For more, see Fertility and Women With Cancer and Fertility and Men With Cancer.

Bone problems: Bone damage or thinning of the bones (osteoporosis) can result from the use of some steroid drugs.

There may be other possible problems from treatment. Your child’s treatment team will review with you before starting treatment.

Long-term follow-up guidelines

To help improve follow-up care of childhood cancer survivors throughout their lives, the Children’s Oncology Group (COG) has written long-term follow-up guidelines for doctors. These guidelines can help you know what to watch for, what types of screening tests should be done, and how late effects can be treated.

It’s very important to discuss possible long-term health effects with your child’s health care team, and to make sure there is a plan in place to watch for these problems and treat them, if needed. To learn more, ask your child’s doctors about the COG survivor guidelines. You can also read them on the COG website: The guidelines are written for health care professionals. Patient versions of some of the guidelines are available (as “Health Links”) on the site as well, but we urge you to discuss them with your doctor.

To learn more about possible late effects of treatment, see Children Diagnosed With Cancer: Late Effects of Cancer Treatment.

Last Medical Review: 05/13/2015
Last Revised: 02/03/2016