Secondary cancers among children with acute lymphoblastic leukaemia treated by the <scp>T</scp>okyo <scp>C</scp>hildren's <scp>C</scp>ancer <scp>S</scp>tudy <scp>G</scp>roup protocols: a retrospective cohort study

Ishida, Yasushi; Maeda, Miho; Urayama, Kevin Y.; Kiyotani, Chikako; Aoki, Yuki; Kato, Yoko; Goto, Shoko; Sakaguchi, Sachi; Sugita, Kenichi; Tokuyama, Mika; Nakadate, Naoya; Ishii, Eizaburo; Tsuchida, Masahiro; Ohara, Akira

doi:10.1111/bjh.12602

Cited by 18 publications

(14 citation statements)

References 27 publications

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“…In Japan, a retrospective cohort study of 2,918 children who received a diagnosis of acute lymphoblastic leukemia (ALL), the most common pediatric malignancy, evaluated the incidence of secondary malignancies and associated factors such as treatment protocols, cranial irradiation (CRT), and other characteristics of primary ALL. The cumulative incidence of all secondary malignancies was 1.0% at 10 years and 2.4% at 20 years 7 . Furthermore, Ishida et al reported that, among 5,387 patients from 15 centers in Japan who survived primary pediatric malignancies, 128 (2.4%) developed secondary malignancies.…”

Section: Introductionmentioning

confidence: 94%

Therapy-related Secondary Malignancy After Treatment of Childhood Malignancy: Cases from a Single Center

et al. 2019

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Background: Therapeutic outcomes for childhood malignancy have dramatically improved. However, secondary malignancies are a major concern, as they greatly affect the quality of life of survivors. This retrospective study evaluated the cumulative incidence, clinical features, and outcomes of secondary malignancies at Nippon Medical School Hospital. Methods: We examined data from 275 cases of primary childhood malignancy diagnosed between 1980 and 2014. Information regarding treatment of the primary malignancy, including irradiation dose, site, and cumulative dose of anticancer drugs, was assessed. We also collected data on secondary malignancy, including patient sex, age at diagnosis, malignancy site, time from primary to secondary malignancy, and outcomes. Results: Secondary malignancies developed in 11 patients and included acute myeloid leukemia (AML) (4), meningioma (4), Ewing sarcoma (1), germ cell tumor (1), and malignant parotid gland tumor (1). The primary malignancies included acute lymphoblastic leukemia (ALL) (9), non-Hodgkin lymphoma (1) and brain tumor (1). In 7 of the 9 ALL patients, chemoradiotherapy was the primary treatment. The meningiomas and 1 solid tumor developed within the radiation field. All AMLs and meningiomas developed within 5 years and after 20 years, respectively, of the primary diagnosis. The 10-and 20-year cumulative incidence rates for secondary malignancy in our hospital were 1.9% and 5.8%, respectively. Conclusions: Our results revealed that the type of secondary malignancy depends on the interval after the end of treatment for primary malignancy. Meningioma, notably, develops many years after completion of primary malignancy treatment. Early detection during long-term follow-up is therefore essential.

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Section: Introductionmentioning

confidence: 94%

Therapy-related Secondary Malignancy After Treatment of Childhood Malignancy: Cases from a Single Center

et al. 2019

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“…Both chemotherapeutic agents and irradiation are potentially genotoxic and may cause secondary malignancy in patients treated with these modalities. Indeed, there are both international and Japanese reports describing secondary cancer . The treatment of leukemia also causes other long‐term sequelae such as chronic health disorders and neurobehavioral problems in cancer survivors .…”

Section: Long‐term Follow Upmentioning

confidence: 99%

“…Indeed, there are both international and Japanese reports describing secondary cancer. 51,56 The treatment of leukemia also causes other long-term sequelae such as chronic health disorders and neurobehavioral problems in cancer survivors. 57 Systematic monitoring of ALL survivors should thus be conducted comprehensively.…”

Section: Long-term Follow Upmentioning

confidence: 99%

Treatment and biology of pediatric acute lymphoblastic leukemia

Kato

Manabe

2018

Pediatrics International

220

175

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Acute lymphoblastic leukemia (ALL) is the most common pediatric malignancy. In the past ALL was intractable but now the survival probability is as high as 80-90%. Improved supportive care, treatment stratification based on relapse risk, biological features of leukemic cells, and optimization of treatment regimens by nationwide and international collaboration have contributed to this dramatic improvement. While including traditional risk factors (e.g. age and leukocyte count at diagnosis), the treatment has been modified based on biological characteristics (aneuploidy and translocation) and treatment response (assessed by minimal residual disease). Treatment for pediatric ALL typically consists of induction therapy with steroids, vincristine, and asparaginase with or without anthracycline, followed by multi-agent consolidation including high-dose methotrexate and re-induction therapy. After consolidation, less intensive maintenance therapy is required for 1-2 years to maintain event-free survival. Recently, using advanced genomic analysis technology, novel sentinel genomic alterations that may provide more precise stratification or therapeutic targets, were identified. Moreover, in the last decade germline variations have been recognized as similarly important contributors to understanding the etiology and sensitivity of ALL to treatment. A more individualized approach based on genomic features (somatic and germline) and treatment response, the introduction of newly developed agents such as molecular targeted drugs or immunotherapy, and social support including long-term follow up are required for further improvement.Key words acute lymphoblastic leukemia, biology, clinical trial, treatment.Acute lymphoblastic leukemia (ALL) is the most common pediatric malignancy and is newly diagnosed in approximately 500 children in Japan annually. A slight male predominance (approx. 1.2-fold higher in boys) has been observed, with a peak incidence at 1-4 years of age. 1 Survival rates were poor 50 years ago, and leukemia was considered to be an intractable disease. Most recent clinical trials, however, have achieved an overall survival probability of 80-90%. The main contributors to this dramatic improvement are the availability of better supportive care, treatment stratification based on relapse risk and the biological features of leukemic cells, and the accumulation of evidence uncovered by clinical trials through nationwide and international collaboration. We herein review the history, current status, and future prospects for the treatment of pediatric ALL, focusing on interventions and biology while excluding infant ALL and relapsed ALL, which have been reported on elsewhere. 2,3

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“…However, long-term survivors of childhood ALL are also at risk for the development of a secondary neoplasm [7131423]. A recent investigation in Japan has found secondary neoplasms development in 37 (2.2%) of 1,716 patients treated after a diagnosis of ALL within a median follow-up duration of 9.5 years [14]. The types of secondary neoplasms in these patients includes hematologic malignancies (acute myeloid leukemia, myelodysplastic syndrome and non-Hodgkin lymphoma), brain tumors and other solid carcinomas.…”

Section: Discussionmentioning

confidence: 99%

“…Whether, in individual cases, the development of a secondary neoplasm is related to the treatment of the previous one is uncertain, because genetic risk factors or other external carcinogens may also be involved. However, it is certain that the risk of a secondary neoplasm developing in patients treated for ALL is higher than that of the normal population and, in fact, a variety of secondary neoplasms, such as brain tumors, hematologic malignancies, sarcomas, thyroid cancers, and skin cancers have been reported in the literature [7131423]. Radiation effects are generally accepted to be a crucial factor in the development of the secondary neoplasm, but the exact mechanism by which this occurs remains unclear [29].…”

Section: Introductionmentioning

confidence: 99%

World Health Organization Grade II Oligodendroglioma Occurring after Successful Treatment for Childhood Acute Lymphoblastic Leukemia

Yoon

Park

et al. 2016

Brain Tumor Res Treat

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When treating childhood acute lymphoblastic leukemia (ALL), secondary neoplasms are a significant long term problem. Radiation is generally accepted to be a major cause of the development of secondary neoplasms. Following treatment for ALL, a variety of secondary tumors, including brain tumors, hematologic malignancies, sarcomas, thyroid cancers, and skin cancers have been reported. However, oligodendroglioma as a secondary neoplasm is extremely rare. Herein we present a case of secondary oligodendroglioma occurring 13 years after the end of ALL treatment.

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Secondary cancers among children with acute lymphoblastic leukaemia treated by the Tokyo Children's Cancer Study Group protocols: a retrospective cohort study

Cited by 18 publications

References 27 publications

Therapy-related Secondary Malignancy After Treatment of Childhood Malignancy: Cases from a Single Center

Therapy-related Secondary Malignancy After Treatment of Childhood Malignancy: Cases from a Single Center

Treatment and biology of pediatric acute lymphoblastic leukemia

World Health Organization Grade II Oligodendroglioma Occurring after Successful Treatment for Childhood Acute Lymphoblastic Leukemia

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