Second neoplasm in children treated in EORTC 58881 trial for acute lymphoblastic malignancies: Low incidence of CNS tumours

Autor: Frédéric Millot, Francoise Mechinaud, Alice Ferster, Anne Uyttebroeck, Emannuel Plouvier, Patrick Boutard, Pierre Philippet, Marleen Renard, Jutte van der Werff ten Bosch, Yves Bertrand, Alain Robert, Els Vandecruys, Brigitte Lescoeur, Yves Benoit, Liliana Baila, Françoise Mazingue, Martine Munzer, Stefan Suciu
Rok vydání: 2011
Předmět:
Zdroj: Pediatric Blood & Cancer. 57:119-125
ISSN: 1545-5009
DOI: 10.1002/pbc.23083
Popis: Background Intensive chemotherapy has markedly improved the survival of children with acute lymphoblastic leukaemia (ALL) or lymphoblastic lymphoma (LL). Evaluation of late effects and analysis of factors contributing to their occurrence has become of major importance. Second neoplasm (SN) belongs to the most severe late events. Procedure We report the incidence of SN which occurred in patients recruited in EORTC trial 58881 for children with ALL or LL. The front-line treatment regimen was adapted from the BFM protocol, but did not include cranial radiotherapy, even in patients with initial involvement of the central nervous system. A total of 2,216 patients were recruited, of whom 2,136 achieved complete remission (CR). Results At a median follow-up of 7.5 years, 22 (1%) patients developed a SN: 20 during or after completion of front-line therapy and 2 in second CR, after relapse treatment including haematopoietic stem cell transplantation (HSCT). Ten patients developed acute myeloblastic leukaemia. Only one SN, a glioblastoma, was a brain tumour. Other SN were: two Hodgkin lymphomas, one non-Hodgkin lymphoma, two thyroid cancers, one osteosarcoma, two soft tissue sarcomas, one Ewing sarcoma, one cutaneous histiocytosis and one peritoneal carcinomatosis. The cumulative incidences of SN at 5, 8 and 13 years after registration were 0.8% (SE 0.2%), 1.0% (SE 0.2%) and 3.0% (SE 1.9%), respectively. Conclusion The overall incidence rate of SN is comparable to that reported previously. In spite of short follow-up time, the low incidence of brain tumours might be related to the omission of cranial radiotherapy. Pediatr Blood Cancer 2011;57:119–125. © 2011 Wiley-Liss, Inc.
Databáze: OpenAIRE
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