1. Secondary cancers among children with acute lymphoblastic leukaemia treated by the Tokyo Children's Cancer Study Group protocols: a retrospective cohort study.
- Author
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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, and Ohara, Akira
- Subjects
LYMPHOBLASTIC leukemia in children ,MEDICAL protocols ,CHILDHOOD cancer ,MYELODYSPLASTIC syndromes ,ACUTE myeloid leukemia ,DIAGNOSIS ,LEUKEMIA treatment - Abstract
With improvement in survival, it is important to evaluate the impact of treatment on secondary cancers in acute lymphoblastic leukaemia ( ALL) survivors. A retrospective cohort study comprising 2918 children diagnosed with ALL and enrolled on Tokyo Children's Cancer Study Group ( TCCSG) protocols between 1984 and 2005 was conducted to evaluate the incidence of secondary cancers and associated factors including treatment protocol, cranial irradiation and other characteristics of the primary ALL. Thirty-seven patients developed secondary cancers, including acute myeloid leukaemia ( n = 11), myelodysplastic syndrome ( n = 5), non- Hodgkin lymphoma ( n = 2), brain tumours ( n = 13) and other solid carcinomas ( n = 6) within a median follow-up duration of 9·5 years. The cumulative incidence of any secondary cancers was 1·0% (95% confidence interval ( CI), 0·7-1·4%) at 10 years and 2·4% (95% CI, 1·5-3·7%) at 20 years, respectively. Standardized incidence rate ratio of secondary cancers was 9·3 (95% CI, 6·5-12·8). Multivariate analyses showed an increased risk of secondary cancers associated with the recent treatment protocol and cranial irradiation. There was no evidence of a reduction in secondary cancer incidence despite marked decreases in cranial irradiation use in the recent protocols. [ABSTRACT FROM AUTHOR]
- Published
- 2014
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