Leukemia After Therapy With for Childhood Cancer
Source: dceg.cancer.gov
Topic: Leukemia
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Sort Desciption: subsequent leukemia risk was determined by a case-control study ... leukemia following Hodgkin's disease (2, 3), ovarian ... leukemia among survivors of ...
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The risk of leukemia was evaluated in 9,170 2-ormore-year survivors of childhood cancer in the 13 institutions of the Late Effects Study Group. Secondary leukemia occurred in 22 nonreferred individuals compared to 1.52 expected, based on general population rates relative risk (RR) = 14; 95% confidence interval (Cl), 9-22 . The influence of therapy for the first cancer on subsequent leukemia risk was determined by a case-control study conducted on 25 cases and 90 matched controls. Treatment with alkylating agents was associated with a significantly elevated risk of leukemia (RR = 4.8; 95% Cl, 1.2-18.9). A strong dose-response relationship was also observed between leukemia risk and total dose of alkylating agents, estimated by an alkylator score. The RR of leukemia reached 23 in the highest dose category. Radiation therapy, however, did not increase risk. Although doxorubicin was also identified as a possible risk factor, the excess risk of leukemia following treatment for childhood cancer appears almost entirely due to alkylating agents.JNCl 1987; 78:459-464. ogy, National Cancer Insittute, National Institutes of health, Public With the advances in treatment of childhood cancer, more children are surviving long periods of time and are at risk of developing late complications of treatment. An excess of leukemia and other cancers in survivors of childhood cancer has previously been reported by the LESG, a collaborative group of 13 major pediatric oncology centers (1). Because the increased risk of leukemia following Hodgkin ...
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