Hematologic cancer survivorship management: Leukemia

The prognosis of patients with leukemia largely depends on the type of leukemia, clinical and pathologic prognostic factors of the leukemic cells, and patient characteristics. Over the past decade, long-term survival rates of patients with chronic myeloid leukemia (CML) have dramatically improved. On the other hand, these patients usually require life-long treatment, which may cause chronic physical, psychological, or socioeconomic complications that can affect patients’ well-being. Chronic lymphocytic leukemia (CLL) is the most common type of leukemia in the United States. The natural history of CLL is generally indolent, with median survival durations of 10 years. Patients with CLL are at risk for secondary malignancies and infectious complications with disease- and treatment-related pathogenesis. Patients with acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL) are generally treated with intensive chemotherapy, which may result in chronic symptoms that interfere with patients’ daily lives. Although some aspects of late or chronic toxic effects of treatment in patients with leukemia have been discussed, data concerning long-term effects remain limited. Further investigation is warranted to establish optimal monitoring schedules and effective interventions for survivors of adult-onset leukemia.