The PETALE study: Late adverse effects and biomarkers in childhood acute lymphoblastic leukemia survivors

Pediatr Blood Cancer. 2017 Jun;64(6). doi: 10.1002/pbc.26361. Epub 2016 Dec 4.

Abstract

Background: Childhood cancer survivorship issues represent an established public health challenge. Most late adverse effects (LAEs) have been demonstrated to be time and treatment dependent. The PETALE study is a multidisciplinary research project aiming to comprehensively characterize LAEs and identify associated predictive biomarkers in childhood acute lymphoblastic leukemia (cALL) survivors.

Methods: cALL survivors treated at Sainte-Justine University Health Center with Dana-Farber Cancer Institution-ALL protocols 87-01 through 2005-01 were eligible. During Phase I of the study, the participants underwent comprehensive clinical, biologic, and psychosocial investigation targeting metabolic syndrome, cardiotoxicity, bone morbidity, neurocognitive problems, and quality of life issues. Whole-exome sequencing was performed for all participants. Subjects identified with an extreme phenotype during Phase I were recalled for additional testing (Phase II).

Results: Phase I included 246 survivors (recall rate 71.9%). Of those, 85 participants completed Phase II (recall rate 88.5%). Survivors agreeing to participate in Phase I (n = 251) were similar to those who refused (n = 31) in terms of relapse risk profile, radiotherapy exposure, and age at the time of study. Participants, however, tended to be slightly older at diagnosis (6.1 vs. 4.7 years old, P = 0.08), with a higher proportion of female agreeing to participate compared with males (93.2 vs. 86.5%, P = 0.07).

Conclusion: The PETALE study will contribute to comprehensively characterize clinical, psychosocial, biologic, and genomic features of cALL survivors using an integrated approach. Expected outcomes include LAE early detection biomarkers, long-term follow-up guidelines, and recommendations for physicians and health professionals.

Keywords: acute lymphoblastic leukemia; biomarkers; childhood cancer; late adverse effects; next-generation sequencing; survivorship.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Biomarkers, Tumor / metabolism*
  • Bone Diseases* / epidemiology
  • Bone Diseases* / etiology
  • Bone Diseases* / metabolism
  • Child
  • Child, Preschool
  • Female
  • Heart Diseases* / epidemiology
  • Heart Diseases* / etiology
  • Heart Diseases* / metabolism
  • Humans
  • Infant
  • Male
  • Metabolic Syndrome* / epidemiology
  • Metabolic Syndrome* / metabolism
  • Neurocognitive Disorders* / epidemiology
  • Neurocognitive Disorders* / etiology
  • Neurocognitive Disorders* / metabolism
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / metabolism*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / mortality
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy*
  • Survivors

Substances

  • Biomarkers, Tumor