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Hearing Status in Survivors of Childhood Acute Myeloid Leukemia Treated With Chemotherapy Only


Skou, Anne-Sofie, MD*; Olsen, Steen Ø., MSc; Nielsen, Lars H., MD, DMSc; Glosli, Heidi, MD, PhD; Jahnukainen, Kirsi, MD, PhD§; Jarfelt, Marianne, MD, PhD; Jónmundsson, Guðmundur K., MD; Malmros, Johan, MD, PhD#,**; Nysom, Karsten, MD, DMSc††; Hasle, Henrik, MD, PhD* On behalf of the Nordic Society of Pediatric Hematology and Oncology (NOPHO)

Journal of Pediatric Hematology/Oncology: January 2019 - Volume 41 - Issue 1 - p e12–e17
doi: 10.1097/MPH.0000000000001302
Online Articles: Original Articles

Background: As more children survive acute myeloid leukemia (AML) it is increasingly important to assess possible late effects of the intensive treatment. Hearing loss has only sporadically been reported in survivors of childhood AML. We assessed hearing status in survivors of childhood AML treated with chemotherapy alone according to 3 consecutive NOPHO-AML trials.

Procedure: A population-based cohort of children treated according to the NOPHO-AML-84, NOPHO-AML-88, and NOPHO-AML-93 trials included 137 eligible survivors among whom 101 (74%) completed a questionnaire and 99 (72%) had otologic and audiologic examination performed including otoscopy (72%), pure tone audiometry (70%), and tympanometry (60%). Eighty-four of 93 (90%) eligible sibling controls completed a similar questionnaire.

Results: At a median of 11 years (range, 4 to 25) after diagnosis, hearing disorders were rare in survivors of childhood AML and in sibling controls, with no significant differences. None had severe or profound hearing loss diagnosed at audiometry. Audiometry detected a subclinical hearing loss ranging from slight to moderate in 19% of the survivors, 5% had low-frequency hearing loss, and 17% had high-frequency hearing loss.

Conclusions: The frequency of hearing disorders was low, and hearing thresholds in survivors of childhood AML were similar to background populations of comparable age.

*Department of Pediatrics, Aarhus University Hospital Skejby, Aarhus

Departments of Otorhinolaryngology, Head and Neck Surgery, and Audiology

††Pediatrics and Adolescent Medicine, University Hospital Rigshospitalet, Copenhagen, Denmark

Department of Pediatric and Adolescent Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway

§Children’s Hospital, Helsinki University Central Hospital, Helsinki, Finland

Department of Pediatric Oncology, The Queen Silvia Children’s Hospital, Gothenburg

#Department of Pediatric Oncology, Karolinska University Hospital

**Department of Women´s and Children’s Health, Karolinska Institutet, Stockholm, Sweden

Department of Pediatrics, Landspitalinn University Hospital, Reykjavik, Iceland

Major financial support was received from: the Danish Cancer Society, the Danish Childhood Cancer Foundation, the Karen Elise Jensen Foundation, and the Swedish Childhood Cancer Foundation.

The authors declare no conflict of interest.

Reprints: Henrik Hasle, MD, PhD, Department of Pediatrics, Aarhus University Hospital Skejby, Palle Juul-Jensens, Boulevard 99, 8200 Aarhus, Denmark (e-mail:

Received April 5, 2018

Accepted July 30, 2018

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