Article (Scientific journals)
Second malignant neoplasms after treatment of childhood acute lymphoblastic leukemia.
Schmiegelow, Kjeld; Levinsen, Mette Frandsen; Attarbaschi, Andishe et al.
2013In Journal of Clinical Oncology, 31 (19), p. 2469-76
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Keywords :
Adolescent; Brain Neoplasms/epidemiology; Child; Child, Preschool; Denmark/epidemiology; Female; Humans; Immunophenotyping; Kaplan-Meier Estimate; Karyotype; Leukemia, Myeloid, Acute/epidemiology; Male; Myelodysplastic Syndromes/epidemiology; Neoplasms, Second Primary/epidemiology/etiology/mortality; Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy; Proportional Hazards Models; Risk Assessment; Risk Factors; Survival Rate
Abstract :
[en] PURPOSE: Second malignant neoplasms (SMNs) after diagnosis of childhood acute lymphoblastic leukemia (ALL) are rare events. PATIENTS AND METHODS: We analyzed data on risk factors and outcomes of 642 children with SMNs occurring after treatment for ALL from 18 collaborative study groups between 1980 and 2007. RESULTS: Acute myeloid leukemia (AML; n = 186), myelodysplastic syndrome (MDS; n = 69), and nonmeningioma brain tumor (n = 116) were the most common types of SMNs and had the poorest outcome (5-year survival rate, 18.1% +/- 2.9%, 31.1% +/- 6.2%, and 18.3% +/- 3.8%, respectively). Five-year survival estimates for AML were 11.2% +/- 2.9% for 125 patients diagnosed before 2000 and 34.1% +/- 6.3% for 61 patients diagnosed after 2000 (P < .001); 5-year survival estimates for MDS were 17.1% +/- 6.4% (n = 36) and 48.2% +/- 10.6% (n = 33; P = .005). Allogeneic stem-cell transplantation failed to improve outcome of secondary myeloid malignancies after adjusting for waiting time to transplantation. Five-year survival rates were above 90% for patients with meningioma, Hodgkin lymphoma, thyroid carcinoma, basal cell carcinoma, and parotid gland tumor, and 68.5% +/- 6.4% for those with non-Hodgkin lymphoma. Eighty-nine percent of patients with brain tumors had received cranial irradiation. Solid tumors were associated with cyclophosphamide exposure, and myeloid malignancy was associated with topoisomerase II inhibitors and starting doses of methotrexate of at least 25 mg/m(2) per week and mercaptopurine of at least 75 mg/m(2) per day. Myeloid malignancies with monosomy 7/5q- were associated with high hyperdiploid ALL karyotypes, whereas 11q23/MLL-rearranged AML or MDS was associated with ALL harboring translocations of t(9;22), t(4;11), t(1;19), and t(12;21) (P = .03). CONCLUSION: SMNs, except for brain tumors, AML, and MDS, have outcomes similar to their primary counterparts.
Disciplines :
Hematology
Oncology
Pediatrics
Author, co-author :
Schmiegelow, Kjeld
Levinsen, Mette Frandsen
Attarbaschi, Andishe
Baruchel, Andre
Devidas, Meenakshi
Escherich, Gabriele
Gibson, Brenda
Heydrich, Christiane
Horibe, Keizo
Ishida, Yasushi
Liang, Der-Cherng
Locatelli, Franco
Michel, Gerard
Pieters, Rob
Piette, Caroline ;  Université de Liège > Département des sciences cliniques > Pédiatrie
Pui, Ching-Hon
Raimondi, Susana
Silverman, Lewis
Stanulla, Martin
Stark, Batia
Winick, Naomi
Valsecchi, Maria Grazia
More authors (12 more) Less
Language :
English
Title :
Second malignant neoplasms after treatment of childhood acute lymphoblastic leukemia.
Publication date :
2013
Journal title :
Journal of Clinical Oncology
ISSN :
0732-183X
eISSN :
1527-7755
Publisher :
American Society of Clinical Oncology, United States - Virginia
Volume :
31
Issue :
19
Pages :
2469-76
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 23 January 2017

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