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Psychosocial sequelae in adult survivors of childhood acute lymphocytic leukemia: A review of the literature

12 December 2003


Leukemia is the most common form of childhood cancer (Brown & MadanSwain, 1993). The literal meaning of the word leukemia is "white blood," a name used to describe a variety of cancers that result from an over-proliferation of white blood cells in bone marrow where blood is fonned. Acute lymphocytic leukemia (formerly called acute lymphoblastic leukemia), or ALL, is the most common cancer diagnosis in children under 15, accounting for 25-30% of all childhood cancers (American Cancer Society [ACS], 2003; Escalon, 1999; Landier, 2001) and nearly 75% of all leukemia diagnoses in children (Leukemia: Acute Lymphoblastic Annual Report, 2001). In 1996, the annual incidence among children in the United States was estimated to be 30-40 per one million children (Gurney, Davis, Severson, Fang, Ross, &Robison, 1996; National Cancer Institute [NCI], 1993) and approximately 2,400 children under the age of20 are diagnosed with ALL each year (NCI, 1993). Because its progression is rapid, untreated ALL is universally fatal.

As medical interventions improve and growing numbers of children survive acute lymphocytic leukemia, research has become increasingly concerned with the quality of survivors' psychological adjustment. What is the psychosocial cost of the cure for these children and their families? Most children who survive ALL exhibit minimal psychosocial sequelae as a result of the illness and its treatment. However, research into repressive coping styles and PTSS-like avoidance suggest that such predictions of adaptive psychosocial adjustment in this population are overly optimistic. As these children progress into adulthood, they may be experiencing more severe psychosocial difficulty than researchers and other professionals recognize.


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