本次审查的目的是提高医疗保健专业人员和政策制定者对儿童白血病幸存者的晚期不良影响的认识和了解。通过现代治疗，超过 90% 的急性淋巴细胞白血病 (ALL) 儿童和超过 60% 的急性髓细胞白血病 (AML) 儿童得到治愈。大型队列研究表明，20% 的 ALL 和大多数 AML 幸存者在诊断后 20-25 年内至少患有一种慢性健康状况。这些会改变或威胁一些幸存者的生活，并导致过早死亡率增加。我们描述了儿童白血病幸存者中最常见和最严重的晚期不良反应的频率、原因、临床特征和自然史，包括随后的恶性肿瘤、代谢毒性、性腺毒性和生育能力受损、内分泌疾病和生长障碍、骨毒性、中枢和神经系统疾病。周围神经毒性、心脏毒性、社会心理迟发效应、加速衰老和迟发死亡率。强调了造血干细胞移植幸存者的广泛后期影响。讨论了长期生存护理方法的最新进展，包括针对患者的电子个性化治疗摘要和护理计划，例如幸存者护照 (SurPass)、监测指南和护理模式。鉴于新型靶向药物的使用越来越多，而长期结果的经验有限，因此强调持续保持警惕的重要性。结论：提高家长、患者、卫生专业人员和政策制定者对儿童白血病治疗迟发效应的存在及其严重性的认识至关重要。结构化的长期监测建议对于标准化后续护理是必要的。版权所有 © 2024 Roganovic 等人。本文可根据知识共享许可（Attribution 4.0 International）获得。

The aim of this review is to raise awareness and knowledge among healthcare professionals and policymakers about late adverse effects in survivors of childhood leukemia. With contemporary treatment, over 90% of children with acute lymphoblastic leukemia (ALL) and over 60% with acute myeloid leukemia (AML) are cured. Large cohort studies demonstrate that 20% of ALL and most AML survivors have at least one chronic health condition by 20-25 years after diagnosis. These are life-changing or threatening in some survivors and contribute to increased premature mortality. We describe the frequency, causes, clinical features, and natural history of the most frequent and severe late adverse effects in childhood leukemia survivors, including subsequent malignant neoplasms, metabolic toxicity, gonadotoxicity and impaired fertility, endocrinopathy and growth disturbances, bone toxicity, central and peripheral neurotoxicity, cardiotoxicity, psychosocial late effects, accelerated ageing and late mortality. The wide range of late effects in survivors of haemopoietic stem cell transplant is highlighted. Recent developments informing the approach to long-term survivorship care are discussed, including electronic personalized patient-specific treatment summaries and care plans such as the Survivor Passport (SurPass), surveillance guidelines and models of care. The importance of ongoing vigilance is stressed given the increasing use of novel targeted drugs with limited experience of long-term outcomes. CONCLUSION: It is vital to raise awareness of the existence and severity of late effects of childhood leukemia therapy among parents, patients, health professionals, and policymakers. Structured long-term surveillance recommendations are necessary to standardize follow-up care.Copyright © 2024 Roganovic et al. This article is available under a Creative Commons License (Attribution 4.0 International).