Second cancers following pediatric Hodgkin's disease.

Wolden, Suzanne L.; Lamborn, Kathleen R.; Cleary, Sean; Tate, David J.; Donaldson, Sarah S.

doi:10.1200/jco.1998.16.2.536

Cited by 256 publications

(144 citation statements)

References 38 publications

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“…How long the risks remain raised is as yet unknown, because of the limited length of follow-up yet available in published studies. Several groups have presented data for 20 and more years of follow-up, finding large and significant relative risks of breast cancer for this time period (Hancock et al, 1993;Bhatia et al, 1996b;Wolden et al, 1998;Metayer et al, 2000;van Leeuwen et al, 2000). One study has published cohort results for 25 and more years, again with a significantly raised risk (Dores et al, 2002) (in a case -control study with no general population comparison, the risk was nonsignificantly raised at 25 and more years for radiation-exposed women (Travis et al, 2003)).…”

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confidence: 99%

“…For patients treated under age 21 years relative risks have generally been around 15 -25 (Hancock et al, 1993;Sankila et al, 1996;Wolden et al, 1998;Metayer et al, 2000;van Leeuwen et al, 2000;Dores et al, 2002), although they have been less raised (Neglia et al, 2001) or more raised (Mauch et al, 1996;Bhatia et al, 1996b;Aisenberg et al, 1997;Ng et al, 2002b) than this in a few studies; absolute excess risks have generally been of the order of 20 -40 per 10 000 per annum. Relative risks have been greater for patients treated at ages 10 -16 than at younger or older ages (Hancock et al, 1993;Sankila et al, 1996;Bhatia et al, 1996b;Metayer et al, 2000).…”

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confidence: 99%

“…One study has published cohort results for 25 and more years, again with a significantly raised risk (Dores et al, 2002) (in a case -control study with no general population comparison, the risk was nonsignificantly raised at 25 and more years for radiation-exposed women ). Relative risks in these studies have usually been somewhat diminished in the longest follow-up period compared with the period preceding it, whereas absolute excess risks, when these have been published, have been at least as great as in the preceding period (Hancock et al, 1993;Wolden et al, 1998;van Leeuwen et al, 2000). Although one cannot be sure what will occur at yet longer follow-up periods, judging from other radiation exposed groups it would be expected that there would be substantial raised risks persisting through 40 or more years of follow-up (Committee on the Biological Effects of Ionizing Radiation (BEIR), 1990).…”

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Second primary breast cancer after Hodgkin's disease

Horwich

Swerdlow

2004

Br J Cancer

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Although the potential carcinogenic risk of radiotherapy is well known, it has become clear that there is a particularly high risk of radiation-induced breast cancer in women treated for Hodgkin's disease at young ages. Thankfully, death from breast cancer in this population is uncommon, but it is important to understand factors contributing to the risk, including treatment parameters, and to develop a logical and efficient method for medical management of those at risk. In this minireview, we examine the evidence which should inform such a management policy. The prognosis of patients with Hodgkin's disease has been improved dramatically over the last 40 years by the development of extended field radiotherapy techniques and then by combination chemotherapy (DeVita et al, 1980;Rosenberg and Kaplan, 1985). However, long-term follow-up of survivors has demonstrated that a price of this success has been an increased risk of second cancers. Acute leukaemia frequently occurs in the first decade after treatment, mainly as a consequence of chemotherapy regimens that included an alkylating agent (Tucker et al, 1988;Kaldor et al, 1990;Swerdlow et al, 2000). In the long term, however, the absolute excess risks of a second solid cancer are higher (Swerdlow et al, 2000;Ng et al, 2002b; and are linked mainly with radiotherapy, although for some sites, such as lung cancer, there may be a substantial risk also from chemotherapy (Swerdlow et al, 2000;Travis et al, 2002). Recent reports from The Netherlands and from an international consortium of cancer registries have refined our understanding of how therapy may affect breast cancer risk.The relative risks of many cancers are higher if patients have been treated for Hodgkin's disease at a younger age (Swerdlow et al, 2000;van Leeuwen et al, 2000;Dores et al, 2002). Thus, although the risk of breast cancer is only about 50% increased in most all-age studies of women with Hodgkin's disease (van Leeuwen et al, 1999), relative risks are far larger than this in patients treated at young ages, especially those treated in childhood and adolescence (Hancock et al, 1993;Bhatia et al, 1996b); for them this is one of the main long-term sequelae of radiotherapy. This effect of age is unsurprising, as similar gradients are seen in other cohorts of radiation-exposed women (United Nations Scientific Committee on the Effects of Atomic Radiation, 1994).The size of risk of breast cancer found in Hodgkin's disease patients has varied between studies. For patients treated under age 21 years relative risks have generally been around 15 -25 (Hancock et al, 1993;Sankila et al, 1996;Wolden et al, 1998;Metayer et al, 2000;van Leeuwen et al, 2000;Dores et al, 2002), although they have been less raised (Neglia et al, 2001) or more raised (Mauch et al, 1996;Bhatia et al, 1996b;Aisenberg et al, 1997;Ng et al, 2002b) than this in a few studies; absolute excess risks have generally been of the order of 20 -40 per 10 000 per annum. Relative risks have been greater for patients treated at ages 10 -16 than at...

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Second primary breast cancer after Hodgkin's disease

Horwich

Swerdlow

2004

Br J Cancer

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“…Children and adolescents with primary multifocal, refractory, or relapsed malignant solid tumors still have a poor prognosis. Moreover, most cancer therapies are associated with signiWcant toxicity leading to long-term morbidity and an increased second malignancy rate [75,135]. Therefore, new treatment strategies are warranted.…”

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confidence: 99%

Targets for active immunotherapy against pediatric solid tumors

Jacobs

Coulie

Figdor

et al. 2008

Cancer Immunol Immunother

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The potential role of antibodies and T lymphocytes in the eradication of cancer has been demonstrated in numerous animal models and clinical trials. In the last decennia new strategies have been developed for the use of tumor-speciWc T cells and antibodies in cancer therapy. EVective anti-tumor immunotherapy requires the identiWcation of suitable target antigens. The expression of tumorspeciWc antigens has been extensively studied for most types of adult tumors. Pediatric patients should be excellent candidates for immunotherapy since their immune system is more potent and Xexible as compared to that of adults. So far, these patients do not beneWt enough from the progresses in cancer immunotherapy, and one of the reasons is the paucity of tumor-speciWc antigens identiWed on pediatric tumors. In this review we discuss the current status of cancer immunotherapy in children, focusing on the identiWcation of tumor-speciWc antigens on pediatric solid tumors.

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“…In a recent report from the Childhood Cancer Survivor study, 488 SMN developed in 13,581 (3.6%) childhood cancer survivors at a median age of 26 years [9]. Although for survivors of childhood ALL, the cumulative risk of a SMN is estimated at 2.0-3.3% 15 years after diagnosis for other malignant disorders, it has been reported to be as high as 9-16% [10,11].…”

Section: Discussionmentioning

confidence: 99%

Second malignant neoplasms in childhood acute lymphoblastic leukemia: Primitive neuroectodermal tumor of the chest wall with germline p53 mutation as a second malignant neoplasm

et al. 2004

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About 80% of children treated for acute lymphoblastic leukemia (ALL) will be long-term survivors. Second malignant neoplasm (SMNs) are a devastating sequelae observed on these children, with an estimated cumulative risk of 2-3.3% fifteen years after diagnosis. Primitive neuroectodermal tumor of bone (PNET) is rarely observed as a SMN following treatment of childhood ALL. The authors described the occurrence of a chest wall PNET of the bone at the site of a central line placement associated with both germ-line and tumor cell p53 mutation in a 8-year-old boy 1 year after completing therapy for standard risk ALL. A review of the literature of 25,051 children treated for ALL discovered 230 SMNs (0.99%), and only one case of PNET of the bone was noted among this group. The occurrence of a SMN in children treated for ALL is a rare event. Such an occurrence, in particular the development of an unusual SMN, should be evaluated for a germline p53 mutation. Am.

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Second cancers following pediatric Hodgkin's disease.

Cited by 256 publications

References 38 publications

Second primary breast cancer after Hodgkin's disease

Second primary breast cancer after Hodgkin's disease

Targets for active immunotherapy against pediatric solid tumors

Second malignant neoplasms in childhood acute lymphoblastic leukemia: Primitive neuroectodermal tumor of the chest wall with germline p53 mutation as a second malignant neoplasm

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