title: Radiation-induced meningiomas: a shadow in the success story of childhood leukemia.
abstract: While the prognosis of acute childhood leukemia has improved, long-term survivors are increasingly experiencing late effects of the treatment. Cranially irradiated survivors are predisposed to the development of CNS tumors. Our aim was to describe the incidence of secondary brain tumors and to define the significance of treatment-related risk factors and host characteristics in a cohort of childhood leukemia survivors. Our cohort consisted of 60 consecutive cranially irradiated adult survivors of childhood leukemia treated in Oulu University Hospital (Oulu, Finland); MRI of the brain was performed on 49. The sites of the tumors, their histology, and details of the leukemia treatment were determined. Of the 49 patients, 11 (22%) 1-8 years of age at the time of diagnosis developed meningioma later in life, while no other brain tumors were seen. In this cohort, the development of meningioma seemed to show undisputable linkage with long latency periods (mean, 25 years; range, 14-34 years) and an increasing incidence 20 years after the treatment (47%). Three patients had multiple meningiomas, two had recurrent disease, and one had an atypical meningioma. Age at the time of irradiation, gender, or cumulative doses of chemotherapeutic agents showed no significant association with the development of meningiomas. The high incidence of meningiomas in this study was associated with long follow-up periods. Although the cohort is small, it seems probable that the increasing incidence of meningioma will shadow the future of cranially irradiated leukemia survivors. Systematic brain imaging after the treatment is therefore justifiable.
authors.affiliation: Department of Pediatric, University Hospital of Oulu, Oulu, Finland.
authors.forename: Joanna
authors.initials: J
authors.lastname: Banerjee
authors.forename: Eija
authors.initials: E
authors.lastname: Pääkkö
authors.forename: Marika
authors.initials: M
authors.lastname: Harila
authors.forename: Riitta
authors.initials: R
authors.lastname: Herva
authors.forename: Juho
authors.initials: J
authors.lastname: Tuominen
authors.forename: Antero
authors.initials: A
authors.lastname: Koivula
authors.forename: Marjatta
authors.initials: M
authors.lastname: Lanning
authors.forename: Arja
authors.initials: A
authors.lastname: Harila-Saari
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D006801:Humans; D015994:Incidence; D007223:Infant; D053208:Kaplan-Meier Estimate; D007938:Leukemia / Q000532:radiotherapy*; D008279:Magnetic Resonance Imaging; D008577:Meningeal Neoplasms / Q000453:epidemiology* / Q000209:etiology; D008579:Meningioma / Q000453:epidemiology* / Q000209:etiology; D009381:Neoplasms, Radiation-Induced / Q000453:epidemiology*; D011878:Radiotherapy / Q000009:adverse effects*; D012307:Risk Factors; D017741:Survivors / Q000706:statistics & numerical data
chemical_list: D000970:Antineoplastic Agents