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Eva Futtrup Maksten,1,2,* Rasmus Rask Kragh Jørgensen,1,2,* Mathilde Selmar Pedersen,1,2 Kirsten Fonager,2,3 Rie Sander Bech,1,2 Ingolf Mølle,4 Andreas Due Ørskov,5 Claudia Schöllkopf,6 Ulrik Malthe Overgaard,6 Gunhild Nynke Thomsen,7 Tarec C El-Galaly,1,2 Marianne Tang Severinsen1,2 1Department of Hematology, Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark; 2Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; 3Department of Social Medicine, Aalborg University Hospital, Aalborg, Denmark; 4Department of Hematology, Aarhus University Hospital, Aarhus, Denmark; 5Department of Hematology, Zealand University Hospital, Roskilde, Denmark; 6Department of Hematology, Copenhagen University Hospital, Copenhagen, Denmark; 7Department of Hematology, Odense University Hospital, Odense, Denmark*These authors contributed equally to this workCorrespondence: Eva Futtrup Maksten, Department of Hematology, Clinical Cancer Research Center, Aalborg University Hospital, Sdr. Skovvej 15, Aalborg, 9000, Denmark, Tel +45 97666864, Fax +45 97666323, Email efm@rn.dkPurpose: Most adult patients diagnosed with acute lymphoblastic leukemia (ALL) are below retirement age. The overall survival of patients with ALL has improved with implementation of high intensity pediatric-inspired treatment protocols. However, this treatment comes with a risk of long-term complications, which could affect the ability to work. The aim of this study was to investigate the risk of disability pension (DP) and return to work (RTW) for patients with ALL.Patients and Methods: Patients aged 18– 60 years diagnosed with ALL between 2005 and 2019 were identified in the Danish National Acute Leukemia Registry. Each patient was matched with five comparators from the general population on birth year, sex, and Charlson Comorbidity Index. The Aalen-Johansen estimator was used to calculate the cumulative risk of DP for patients and comparators from index date (defined as 1 year after diagnosis) with competing events (transplantation or relapse, death, retirement pension, or early retirement pension). Differences in cumulative incidences were calculated using Gray’s test. RTW was calculated as proportions one, three, and five years after the index date for patients holding a job before diagnosis.Results: A total of 154 patients with ALL and 770 matched comparators were included. The 5-year cumulative risk of DP was increased fivefold for patients with ALL compared with the general population. RTW was 41.7%, 65.7%, and 60.7% one, three, and five years after the index date, respectively.Conclusion: The risk of DP in patients with ALL increased significantly compared with the general population. Five years after the index date, RTW was 60.7% for patients with ALL.Keywords: acute lymphoblastic leukemia, disability pension, return to work