Association between fetal growth restriction and late complications in long-term survivors of pediatric acute lymphoblastic leukemia

Purpose: This study aimed to investigate the association between fetal growth restriction (FGR) and the development of late complications in long-term survivors of pediatric acute lymphoblastic leukemia (ALL). Materials and Methods: This study enrolled 108 long-term survivors of pediatric ALL, who were subsequently divided into two groups. Group 1 consisted of 48 patients with a history of FGR, while Group 2 included 60 patients with normal fetal growth. The groups were compared based on demographic characteristics, treatment status, duration of remission, maternal and paternal age at conception, maternal weight gain during pregnancy, parental smoking and alcohol use, and the incidence of late complications. Results: No significant association was found between the groups regarding treatment status, demographic factors, remission duration, or familial risk factors. However, the number of late complications was statistically significantly higher in Group 1 (37/48, 77.1%) compared to Group 2 (18/60, 30.0%). The most frequently observed late complications were endocrine (47/108), cardiac (21/108), osseous (18/108), metabolic (8/108), and neurological (3/108). Conclusion: ALL treatment may induce late complications by affecting various systems and tissues through oxidative mechanisms, particularly in patients with a history of FGR. Our findings may aid clinicians in predicting the risk of late complications and developing early prevention strategies for ALL survivors with a history of FGR.