Late effects risk profiles using the long-term follow-up guidelines in identical twin survivors of acute lymphoblastic leukemia

As the number of pediatric cancer survivors increases, the cost of cure (i.e., late effects) needs to be measured through a consistent mechanism. Through the use of the Children's Oncology Group's (COG) Long-Term Follow-Up (LTFU) guidelines, individualized risk profiles can be discerned for each off-therapy patient. These guidelines were used to compare and contrast risk profiles for identical twin females treated for acute lymphoblastic leukemia (ALL). The first twin was treated for high-risk leukemia and the second for standard-risk leukemia, each with different ALL protocols. Timely use of the LTFU guidelines has aided in identifying and treating their adverse late effects.