Components of comprehensive long-term follow-up of AYA leukemia survivors
| Organ system or patient-centered care category . | Specific toxicities or outcomes that impact survival, health, or quality of life . |
|---|---|
| Overall survival | Premature mortality |
| Cancer recurrence or SN | |
| Cardiac | Cardiomyopathy |
| Cardiometabolic | Obesity |
| Dyslipidemia | |
| Hypertension | |
| Insulin resistance, diabetes | |
| Endocrine/gonadal | Anterior pituitary hormone deficiencies in GH, FSH, LH, ACTH, TSH |
| Ovarian dysfunction, estrogen and progesterone deficiency | |
| Testicular dysfunction, oligospermia or azoospermia, testosterone deficiency, germinal epithelium damage, Leydig cell dysfunction | |
| Reproductive | Infertility |
| Sexual dysfunction | |
| Musculoskeletal | ON |
| Osteopenia/osteoporosis | |
| Sarcopenia with increased adiposity | |
| Health behaviors | Risky behaviors (smoking, alcohol, sexual behavior) |
| Diet and exercise | |
| Health care needs | Chronic health conditions |
| Demands of routine surveillance | |
| Nonadherence to medication and screening | |
| Lack of information | |
| Access to care | |
| Health fears leading to over- or undertreatment | |
| Emotional adjustment | Living with uncertainty, fear of recurrence |
| Infertility impacts | |
| Sexual dysfunction impacting relationships and self-perception | |
| Body image with self-consciousness | |
| Hypervigilance | |
| Posttraumatic stress | |
| Distress, anxiety, depression | |
| Suicidal ideation | |
| Sense of personal growth | |
| Social relationships | Family difficulties: parents, spouse, children |
| Peers comparison or separation | |
| Dating, intimacy | |
| Decreased social and leisure activities | |
| Isolation with decreased social support | |
| Need for multiple health care provider relationships | |
| Functional needs/symptoms | Managing physical limitations |
| Fatigue | |
| Cognitive dysfunction | |
| Sexual function symptoms | |
| Insomnia | |
| Employment/finances | Education completion |
| Career advancement | |
| Debt and financial stress | |
| Insurance coverage |
| Organ system or patient-centered care category . | Specific toxicities or outcomes that impact survival, health, or quality of life . |
|---|---|
| Overall survival | Premature mortality |
| Cancer recurrence or SN | |
| Cardiac | Cardiomyopathy |
| Cardiometabolic | Obesity |
| Dyslipidemia | |
| Hypertension | |
| Insulin resistance, diabetes | |
| Endocrine/gonadal | Anterior pituitary hormone deficiencies in GH, FSH, LH, ACTH, TSH |
| Ovarian dysfunction, estrogen and progesterone deficiency | |
| Testicular dysfunction, oligospermia or azoospermia, testosterone deficiency, germinal epithelium damage, Leydig cell dysfunction | |
| Reproductive | Infertility |
| Sexual dysfunction | |
| Musculoskeletal | ON |
| Osteopenia/osteoporosis | |
| Sarcopenia with increased adiposity | |
| Health behaviors | Risky behaviors (smoking, alcohol, sexual behavior) |
| Diet and exercise | |
| Health care needs | Chronic health conditions |
| Demands of routine surveillance | |
| Nonadherence to medication and screening | |
| Lack of information | |
| Access to care | |
| Health fears leading to over- or undertreatment | |
| Emotional adjustment | Living with uncertainty, fear of recurrence |
| Infertility impacts | |
| Sexual dysfunction impacting relationships and self-perception | |
| Body image with self-consciousness | |
| Hypervigilance | |
| Posttraumatic stress | |
| Distress, anxiety, depression | |
| Suicidal ideation | |
| Sense of personal growth | |
| Social relationships | Family difficulties: parents, spouse, children |
| Peers comparison or separation | |
| Dating, intimacy | |
| Decreased social and leisure activities | |
| Isolation with decreased social support | |
| Need for multiple health care provider relationships | |
| Functional needs/symptoms | Managing physical limitations |
| Fatigue | |
| Cognitive dysfunction | |
| Sexual function symptoms | |
| Insomnia | |
| Employment/finances | Education completion |
| Career advancement | |
| Debt and financial stress | |
| Insurance coverage |
ACTH, adrenocorticotrophic hormone; FSH, follicle-stimulating hormone; LH, luteinizing hormone; TSH, thyroid-stimulating hormone.