title: Second neoplasm in children treated in EORTC 58881 trial for acute lymphoblastic malignancies: low incidence of CNS tumours.
abstract: BACKGROUND
  Intensive chemotherapy has markedly improved the survival of children with acute lymphoblastic leukaemia (ALL) or lymphoblastic lymphoma (LL). Evaluation of late effects and analysis of factors contributing to their occurrence has become of major importance. Second neoplasm (SN) belongs to the most severe late events.
  
  
  METHODS
  We report the incidence of SN which occurred in patients recruited in EORTC trial 58881 for children with ALL or LL. The front-line treatment regimen was adapted from the BFM protocol, but did not include cranial radiotherapy, even in patients with initial involvement of the central nervous system. A total of 2,216 patients were recruited, of whom 2,136 achieved complete remission (CR).
  
  
  RESULTS
  At a median follow-up of 7.5 years, 22 (1%) patients developed a SN: 20 during or after completion of front-line therapy and 2 in second CR, after relapse treatment including haematopoietic stem cell transplantation (HSCT). Ten patients developed acute myeloblastic leukaemia. Only one SN, a glioblastoma, was a brain tumour. Other SN were: two Hodgkin lymphomas, one non-Hodgkin lymphoma, two thyroid cancers, one osteosarcoma, two soft tissue sarcomas, one Ewing sarcoma, one cutaneous histiocytosis and one peritoneal carcinomatosis. The cumulative incidences of SN at 5, 8 and 13 years after registration were 0.8% (SE 0.2%), 1.0% (SE 0.2%) and 3.0% (SE 1.9%), respectively.
  
  
  CONCLUSIONS
  The overall incidence rate of SN is comparable to that reported previously. In spite of short follow-up time, the low incidence of brain tumours might be related to the omission of cranial radiotherapy.
authors.affiliation: University Hospital Leuven, Leuven, Belgium. marleen.renard@uzleuven.be
authors.forename: Marleen
authors.initials: M
authors.lastname: Renard
authors.forename: Stefan
authors.initials: S
authors.lastname: Suciu
authors.forename: Yves
authors.initials: Y
authors.lastname: Bertrand
authors.forename: Anne
authors.initials: A
authors.lastname: Uyttebroeck
authors.forename: Alice
authors.initials: A
authors.lastname: Ferster
authors.forename: Jutte
authors.initials: J
authors.lastname: van der Werff Ten Bosch
authors.forename: Françoise
authors.initials: F
authors.lastname: Mazingue
authors.forename: Emannuel
authors.initials: E
authors.lastname: Plouvier
authors.forename: Alain
authors.initials: A
authors.lastname: Robert
authors.forename: Patrick
authors.initials: P
authors.lastname: Boutard
authors.forename: Frédéric
authors.initials: F
authors.lastname: Millot
authors.forename: Martine
authors.initials: M
authors.lastname: Munzer
authors.forename: Françoise
authors.initials: F
authors.lastname: Mechinaud
authors.forename: Brigitte
authors.initials: B
authors.lastname: Lescoeur
authors.forename: Liliana
authors.initials: L
authors.lastname: Baila
authors.forename: Els
authors.initials: E
authors.lastname: Vandecruys
authors.forename: Yves
authors.initials: Y
authors.lastname: Benoit
authors.forename: Pierre
authors.initials: P
authors.lastname: Philippet
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects; D001215:Asparaginase / Q000008:administration & dosage / Q000009:adverse effects; D016543:Central Nervous System Neoplasms / Q000401:mortality* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D002986:Clinical Trials as Topic; D003630:Daunorubicin / Q000008:administration & dosage / Q000009:adverse effects; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D016609:Neoplasms, Second Primary / Q000401:mortality* / Q000628:therapy; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000401:mortality* / Q000628:therapy; D011241:Prednisone / Q000008:administration & dosage / Q000009:adverse effects; D012074:Remission Induction; D012189:Retrospective Studies; D015996:Survival Rate; D014750:Vincristine / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D014750:Vincristine; D001215:Asparaginase; D011241:Prednisone; D003630:Daunorubicin