AI Article Synopsis
- - Childhood acute leukemias and lymphomas have high survival rates, but can lead to second neoplasms (SN), with 1% of patients developing SN over nearly 30 years of study.
- - Among the 34 patients with SN, the most common types included acute leukemias and various solid tumors, with a significantly longer latency period for solid tumors compared to hematological malignancies.
- - Treatment of SN, considering previous therapy doses, resulted in a 67.6% complete remission rate, indicating that patients can have survival rates similar to those diagnosed with new cancers.
Article Abstract
Introduction: Childhood acute leukemias (AL) and lymphomas achieve good survival rates. However, second neoplasms (SN) are a devastating event.
Methods: From August 1987 to December 2016, 34 of 3321 (1%) patients with diagnosis of AL or lymphoma developed SN. SN were AL (n=16), CNS tumors (n=5), endocrinal tumors (n=3), lymphomas (n=2), schwannoma (n=2) assorted sarcomas (n=4), retinal melanoma (n=1), and Vanek tumor (n=1). Median latency was 51 (range, 10 to 110) months for hematological malignancies and 119 (range, 25 to 236) months for solid tumors (P=0.001).
Results: A total of 33 patients with SN were treated taking into account cumulative doses of anthracyclines and radiotherapy. Twenty-three (67.6%) patients achieved complete remission (CR), 5 died early during therapy and 5 were refractory or partial responders. Six patients presented relapses of the SN and 1 died in CR. Seventeen patients remain alive in CR, with a median follow-up of 110 (range, 4 to 276) months.
Conclusions: (1) The latency period was significantly longer for patients developing solid tumors than for those developing AL. (2) AL was the most frequent SN. (3) Our results strongly encourage giving standard therapy to SN, considering cumulative doses of previous treatment, since similar probabilities of surviving as "de novo" counterparts can be achieved.
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| http://dx.doi.org/10.1097/MPH.0000000000000971 | DOI Listing |
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