Second malignant neoplasms after treatment of childhood acute lymphoblastic leukemia
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Second malignant neoplasms after treatment of childhood acute lymphoblastic leukemia. / 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, Gérard; Pieters, Rob; Piette, Caroline; Pui, Ching-Hon; Raimondi, Susana; Silverman, Lewis; Stanulla, Martin; Stark, Batia; Winick, Naomi; Valsecchi, Maria Grazia.
In: J CLIN ONCOL, Vol. 31, No. 19, 01.07.2013, p. 2469-76.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Second malignant neoplasms after treatment of childhood acute lymphoblastic leukemia
AU - Schmiegelow, Kjeld
AU - Levinsen, Mette Frandsen
AU - Attarbaschi, Andishe
AU - Baruchel, Andre
AU - Devidas, Meenakshi
AU - Escherich, Gabriele
AU - Gibson, Brenda
AU - Heydrich, Christiane
AU - Horibe, Keizo
AU - Ishida, Yasushi
AU - Liang, Der-Cherng
AU - Locatelli, Franco
AU - Michel, Gérard
AU - Pieters, Rob
AU - Piette, Caroline
AU - Pui, Ching-Hon
AU - Raimondi, Susana
AU - Silverman, Lewis
AU - Stanulla, Martin
AU - Stark, Batia
AU - Winick, Naomi
AU - Valsecchi, Maria Grazia
PY - 2013/7/1
Y1 - 2013/7/1
N2 - 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.
AB - 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.
KW - Adolescent
KW - Brain Neoplasms
KW - Child
KW - Child, Preschool
KW - Denmark
KW - Female
KW - Humans
KW - Immunophenotyping
KW - Kaplan-Meier Estimate
KW - Karyotype
KW - Leukemia, Myeloid, Acute
KW - Male
KW - Myelodysplastic Syndromes
KW - Neoplasms, Second Primary
KW - Precursor Cell Lymphoblastic Leukemia-Lymphoma
KW - Proportional Hazards Models
KW - Risk Assessment
KW - Risk Factors
KW - Survival Rate
U2 - 10.1200/JCO.2012.47.0500
DO - 10.1200/JCO.2012.47.0500
M3 - SCORING: Journal article
C2 - 23690411
VL - 31
SP - 2469
EP - 2476
JO - J CLIN ONCOL
JF - J CLIN ONCOL
SN - 0732-183X
IS - 19
ER -
