New Malignant Diseases After Allogeneic Marrow Transplantation for Childhood Acute Leukemia

Socié, Gèrard; Curtis, Rochelle E.; Deeg, H. Joachim; Sobocinski, Kathleen A.; Filipovich, Alexandra H.; Travis, Lois B.; Sullivan, Keith M.; Rowlings, Philip; Kingma, DW; Banks, Peter M.; Travis, William D.; Witherspoon, RP; Sanders, Jean E.; Jaffe, Elaine S.; Horowitz, Mary M.

doi:10.1200/jco.2000.18.2.348

Cited by 301 publications

(262 citation statements)

References 42 publications

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“…11,19,[20][21][22][23][24] Radiation and chemotherapy used for treatment of primary disease and in conditioning regimens, as well as profound immunosuppression post allo-HSCT have been identified as contributing factors. 19,20 In our cohort (429 patients), the CI rate of secondary malignancy was 4.3% at 17.6 years with a median time of 6.8 years post allo-HSCT (Figure 2).…”

Section: Discussionmentioning

confidence: 99%

Long-term outcome after allo-SCT: close follow-up on a large cohort treated with myeloablative regimens

Abou-Mourad

Lau

Barnett

et al. 2009

Bone Marrow Transplant

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We analyzed the late outcomes of 429 long-term survivors post allogeneic hematopoietic SCT (allo-HSCT) who received transplant in our center between 1981 and 2002, and were free of their primary disease for X2 years after allo-HSCT. Late recurrent primary malignancy was found in 58 (13.5%) patients and was the primary cause of late death. A total of 37 (8.6%) patients died of nonrelapse causes at a median of 5.5 years (range, 2-15.6 years) post allo-HSCT. The major non-relapse causes of death were chronic GVHD (cGVHD), secondary malignancy and infection. The probabilities of OS and EFS were 85% (95% cumulative incidence (CI) (81-89%)) and 79% (95% CI (74-83%)) at 10 years, respectively. Long-term allo-HSCT survivors were evaluated for late complications (median follow-up, 8.6 years (range, 2.3-22.8 years)). cGVHD was diagnosed in 196 (53.1%) survivors. The endocrine and metabolic complications were hypogonadism in 134 (36.3%) patients, osteopenia/ osteoporosis in 90 (24.4%), dyslipidemia in 33 (8.9%), hypothyroidism in 28 (7.6%) and diabetes in 28 (7.6%). Hypertension was diagnosed in 79 (21.4%), renal impairment in 70 (19.0%), depression in 40 (10.8%) and sexual dysfunction in 33 (8.9%) survivors. We conclude that in patients who receive allo-HSCT as treatment for hematological malignancy and who are free of their original disease 2 years post transplant, mortality is low and the probability of durable remission is high. Lifelong surveillance is recommended.

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Section: Discussionmentioning

confidence: 99%

Long-term outcome after allo-SCT: close follow-up on a large cohort treated with myeloablative regimens

Abou-Mourad

Lau

Barnett

et al. 2009

Bone Marrow Transplant

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“…The reported rate in the literature ranges from 6.1 to 12.8%. 4,6,8,[15][16][17] This difference might be attributable to the fact that our cohort was strictly pediatric. Comparable rates to those observed in our study were reported in a single study of pediatric and adults survivors of allogeneic transplant (15-year incidence of 2.2%).…”

Section: Discussionmentioning

confidence: 99%

“…4,[6][7][8][9] Those studies that report on pediatric populations consistently report an inverse relationship between age at transplantation and risk of post-HSCT SMN. 4,6,8 However, little is known about the independent contribution of HSCT to the development of SMNs. It is important to characterize and compare the risk of developing SMN in children with malignancies treated with and without HSCT to understand any differences in risk.…”

Section: Introductionmentioning

confidence: 99%

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Subsequent malignant neoplasms in pediatric cancer patients treated with and without hematopoietic SCT

Pole

Darmawikarta

Gassas

et al. 2015

Bone Marrow Transplant

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Pediatric cancer patients are at increased risk of subsequent malignant neoplasms (SMNs). However, little is known about the contribution of hematopoietic SCT (HSCT) to the development of SMNs. The objective of this study was to compare the incidence of SMNs in a population cohort of childhood cancer survivors treated with and without HSCT. A cohort of 7986 children (age 0-14 years) diagnosed with cancer in the province of Ontario, Canada between 1985 and 2009 was identified in POGONIS (Pediatric Oncology Group of Ontario Networked Information System), a population-based active cancer registry, and linked to a clinical HSCT database. Among this cohort, 796 patients had an HSCT as part of their primary treatment. Of the 375 allogeneic HSCT patients, 14 (3.7%) developed a SMN at a median follow-up of 12.3 years (range: 2.0-22.9 years). Of the 421 autologous HSCT patients, 8 (1.9%) developed a SMN at a median of 4.5 years (range: 1.3-14.3 years). Of the 7190 patients who did not receive an HSCT, 160 (2.2%) developed a SMN at a median follow-up of 6.8 years (range: 0.0-24.9 years). The 15-year cumulative incidence of SMN was 3.1% among the allogeneic HSCT group, 2.5% among the autologous group and 2.3% in the non-HSCT group. The cumulative incidence curves for the allogeneic HSCT and non-transplant groups only diverged after~15 years from primary diagnosis. Our findings further corroborate the observation that children who undergo allogeneic HSCT are at a significantly increased risk of developing SMN compared with pediatric cancer survivors treated without HSCT.

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“…Being at risk after radiation therapy alone, chemotherapy alone and combined chemo-and radiotherapy, these risks apply to patients who undergo HSCT at a younger age, 48 although a genetic predisposition may have a role in the development of second malignant neoplasms. 49 Socie`et al 50 reported higher risk of occurrence of solid tumours in paediatric patients transplanted below the age of 5 years. Cancer of the brain and thyroid did represent half of all secondary tumours occurring most frequently in very young transplanted patients.…”

Section: Second Malignant Neoplasmsmentioning

confidence: 99%

Non-endocrine late complications in children after allogeneic haematopoietic SCT

Faraci¹,

Békássy

Fazio³

et al. 2008

Bone Marrow Transplant

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New Malignant Diseases After Allogeneic Marrow Transplantation for Childhood Acute Leukemia

Abstract: Long-term survivors of BMT for childhood leukemia have an increased risk of solid cancers and PTLDs, related to both transplant therapy and treatment given before BMT. Transplant recipients, especially those given radiation, should be monitored closely for second cancers.

Cited by 301 publications

References 42 publications

Long-term outcome after allo-SCT: close follow-up on a large cohort treated with myeloablative regimens

Long-term outcome after allo-SCT: close follow-up on a large cohort treated with myeloablative regimens

Subsequent malignant neoplasms in pediatric cancer patients treated with and without hematopoietic SCT

Non-endocrine late complications in children after allogeneic haematopoietic SCT

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