Myeloid neoplasia in children treated for solid tumours.
Therapy-related myeloid neoplasia developed 14 to 189 months after diagnosis of the primary malignancy in 12 out of 3365 children treated for malignant solid tumours; 6 of the 12 were in their first complete remission. The 10-year cumulative incidence of myeloid neoplasia was 1.3% (95% Cl 0.5-3.6) for the 447 patients with Hodgkin's disease, 1.3% (0.4-4.3) for the 420 with non-Hodgkin lymphoma, and 1.2% (0.3-5.2) for the 440 with neuroblastoma. This complication appeared in 1 of 180 children with brain tumours and in none of the 1878 with other malignancies. Risk of therapy-related myeloid neoplasia in patients with Hodgkin's disease was associated with recurrence of the primary malignancy, a combination of radiotherapy and chemotherapy with alkylating agents, and age greater than or equal to 12 years at diagnosis of Hodgkin's disease. Of the 8 patients who underwent chromosomal analysis of neoplastic myeloid cells, 2 showed complete loss of chromosome 7 and 4 showed t(9;11) or t(8;21) with or without del(16)(q22). The 2 patients who had received an epipodophyllotoxin had an 11q23 abnormality. The risk of therapy-related myeloid neoplasia is low in children with malignant solid tumours.
Pui
C H
CH
Department of Hematology-Oncology, St. Jude Children's Research Hospital, Memphis, TN 38101.
Hancock
M L
ML
Raimondi
S C
SC
Head
D R
DR
Thompson
E
E
Wilimas
J
J
Kun
L E
LE
Bowman
L C
LC
Crist
W M
WM
Pratt
C B
CB
D000293:Adolescent; D000328:Adult; D000477:Alkylating Agents / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D002869:Chromosome Aberrations; D002897:Chromosomes, Human, Pair 7; D015331:Cohort Studies; D005260:Female; D006689:Hodgkin Disease / Q000188:drug therapy / Q000532:radiotherapy; D006801:Humans; D015994:Incidence; D007223:Infant; D007621:Karyotyping; D015470:Leukemia, Myeloid, Acute / Q000209:etiology* / Q000235:genetics; D008297:Male; D009190:Myelodysplastic Syndromes / Q000209:etiology* / Q000235:genetics; D009369:Neoplasms / Q000628:therapy*; D011878:Radiotherapy / Q000009:adverse effects; D012307:Risk Factors; D013223:Statistics as Topic
D000477:Alkylating Agents