Second Neoplasms after Acute Lymphoblastic Leukemia in Childhood

Neglia, Joseph P.; At, Meadows; Ll, Robison; Kim, Tae Hee; Wa, Newton; Fb, Ruymann; Hn, Sather; Gd, Hammond

doi:10.1056/nejm199111073251902

Cited by 496 publications

(287 citation statements)

References 30 publications

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“…In total 230 SMNs (0.99%) were reported among 23,051 children treated for ALL (Table I). This percentage (0.99%) is similar to the 1.18% and 2.5% cumulative risk of SMN at 10 years and 15 years, respectively, reported by Bhatia and Neglia [3,4]. The most common SMNs observed in this review were CNS tumors (31.7%) followed by AML/MDS (16.5%), thyroid cancer (10%), lymphomas (8.2%), and skin cancer (7.8%).…”

Section: Discussionsupporting

confidence: 83%

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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Section: Discussionsupporting

confidence: 83%

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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“…A significant amount of information regarding second malignancies following treatment of Hodgkin disease, [1][2][3] retinoblastoma, 4 -6 and acute lymphoblastic leukemia (ALL) 7 is available because a good cure rate has been achieved for many years, resulting in many long-term survivors.…”

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confidence: 99%

Second malignant neoplasms in long‐term survivors of osteosarcoma

Aung

Görlick

Shi

et al. 2002

Cancer

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BACKGROUNDThe authors investigated the incidence and relative risk of secondary malignant neoplasms in long‐term survivors of osteosarcoma.METHODSA comprehensive list of 509 patients with primary osteosarcoma treated at our institution between February 1973 and March 2000 was identified. All study patients received chemotherapy and/or surgery on one of six different protocols (T4, 5, 7, 10, 12, and CCG‐7921/POG‐9351). Chemotherapy was scheduled for up to 40 weeks with some variations in the actual treatment period and consisted of various combinations of the following agents: high‐dose methotrexate, doxorubicin, bleomycin, cyclophosphamide, dactinomycin, vincristine, cisplatin, and ifosfamide.RESULTSSecondary malignant neoplasms (SMN) occurred in 14 of 509 patients. Only one had pulmonary metastasis at diagnosis and subsequent multiple recurrences that required thoracotomies and further modification of the chemotherapy regimen. The median age at diagnosis for osteosarcoma was 16.6 years (range, 3.1–74.4 years). The median follow‐up was 5.2 years (range, 0.1–25.0 years). The time interval from diagnosis of the primary osteosarcoma to the development of SMN was 1.3–13.1 years (median, 5.5; 95% confidence interval [CI], 3.6–9.6). The most common SMN occurred in the central nervous system (n = 4): anaplastic glioma, meningioma, high‐grade glioma, and maxillary astrocytoma. There were two cases of acute myeloid leukemia and one case each of myelodysplastic syndrome, non‐Hodgkin lymphoma, high‐grade pleomorphic sarcoma, leiomyosarcoma, fibrosarcoma, breast carcinoma, and mucoepidermoid carcinoma. The overall 5 and 10‐year cumulative incidences of SMNs were 1.4% ± 1.1% and 3.1% ± 1.8%. The standardized incidence ratio was 4.6 (95% CI, 2.53–7.78, P = 0.00001) for the cohort and 3.64 (95% CI, 1.82–6.52, P = 0.0007) when patients with a history of retinoblastoma or Rothmund‐Thomson syndrome were excluded.CONCLUSIONSThe overall incidence of secondary malignancies in long‐term survivors of osteosarcoma was significantly higher than the expected incidence of cancer in the general population. However, the standardized incidence ratios were much lower than those reported for Hodgkin disease and retinoblastoma. Although additional follow‐up is warranted, the successes of current treatment regimens consisting of intensive, high‐dose chemotherapy in combination with topoisomerase II inhibitors outweigh the risks. Cancer 2002;95:1728–34. © 2002 American Cancer Society.DOI 10.1002/cncr.10861

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“…22 Osteosarcoma following ALL, on the other hand, seems to be very rare. No osteosarcomas were detected in a population-based series of eight second malignant neoplasms in 895 childhood ALL patients, 23 none among 43 second neoplasms in 9720 children with ALL treated according to the therapeutic protocols of the Children's Cancer Study Group, 24 and only one of 52 second neoplasms among 5006 ALL patients observed by the BFM group until 1997 25 (corresponding to patient 1 from this report, Schrappe M, personal communication) was an osteosarcoma. Evidence suggestive of a familial cancer predisposition was present in two of our three ALL patients.…”

Section: Discussionmentioning

confidence: 65%

Osteosarcoma after allogeneic bone marrow transplantation. A report of four cases from the Cooperative Osteosarcoma Study Group (COSS)

Bielack

Rerin

Dickerhoff

et al. 2003

Bone Marrow Transplant

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Second Neoplasms after Acute Lymphoblastic Leukemia in Childhood

Abstract: There is a substantial excess of second neoplasms, especially of the central nervous system, among children treated for ALL. Children five years old or younger and those receiving radiation are at higher risk, especially for second tumors arising in the central nervous system.

Cited by 496 publications

References 30 publications

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

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

Second malignant neoplasms in long‐term survivors of osteosarcoma

Osteosarcoma after allogeneic bone marrow transplantation. A report of four cases from the Cooperative Osteosarcoma Study Group (COSS)

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