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Lymphoblastic Leukemia Survivors at Risk for Secondary Cancer

A new study finds that survivors of acute lymphoblastic leukemia have a significantly increased risk of secondary cancers when compared to the general population. //

Acute lymphoblastic leukemia is the most common cancer in children and adolescents, with almost 4,000 new cases diagnosed in the United States each year. It is also one of the most curable pediatric cancers: survival rates for patients who receive contemporary treatments now exceed 80 percent, and most of these survivors are cured (no evidence of disease for at least 10 years).

"Accordingly, characterization of long-term outcomes in acute lymphoblastic leukemia patients who remain in first complete remission for at least a decade has assumed increasing importance, especially in view of the long life expectancy of this survivor population." But little is known about the incidence of secondary tumors or cancer after 15 to 20 years in children and adolescents who were treated for acute lymphoblastic leukemia.

Nobuko Hijiya, M.D., of St. Jude Children's Research Hospital, Memphis, Tenn., and colleagues conducted a study to estimate the long-term (30-year) cumulative incidence of secondary neoplasms (cancers) in 2,169 children and adolescents treated for acute lymphoblastic leukemia between 1962 and 1998 at St. Jude Children's Research Hospital. The patients had achieved complete remission and had a median (mid-point) follow-up time of 18.7 years (range, 2.4 - 41.3 years).

The researchers found that among the 1,290 patients who remained in complete remission, 123 (9.5 percent) developed a secondary neoplasm as their first event. The cumulative incidence of secondary neoplasms in all patients as the first event after complete remission was 4.17 percent at 15 years, increasing to 5.37 percent at 20 years and to 10.85 percent at 30 years. "The relatively rapid increase in incidence at 20 years after complete remission can be attributed largely to the late development of me
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