Second Malignancy in Acute Lymphocytic Leukemia

Abstract

\s=b\ Improved survival in childhood cancer resulting from advances in therapy is frequently associated with long-term morbidity, including the potential for second malignancy. In a review of the literature in the English language, we found 33 cases of acute lymphocytic leukemia (ALL) followed by a second neoplasm. Second tumors in this group of patients with ALL include seven cases of histiocytic medullary reticulosis, four cases of Hodgkin's disease, nine cases of acute myelocytic leukemia, four cases of chronic myelocytic leukemia, and nine cases of solid tumors. The appearance of subsequent malignancies may be related to a combination of therapy-induced immunosuppression, a direct carcinogenic effect resulting from therapy, and/or constitutional factors. Physicians should be alert to the possibility of subsequent malignant neoplasms in survivors of cancer.

Second Malignant Neoplasms in Patients Treated for Childhood Leukemia: A Population‐based Cohort Study from the Nordic Countries

“…The pattern of other solid tumors found in this study is in accordance with previous reports (1 3, 28,35). Rhabdomyosarcoma has earlier been registered in an ALL survivor who had only received chemotherapy (36).…”

Low incidence of second neoplasms among children diagnosed with acute lymphoblastic leukemia after 1983

“…[10][11][12][13][14][15][16][17][44][45][46] In a CCG report of 9720 patients diagnosed between 1972 and 1988 and observed for a median of 4.7 years, For…”

“…2 With 2500 to 3000 children diagnosed with ALL annually, we expect approximately 2000 long-term survivors of childhood ALL each year. Long-term sequelae of treatment, such as impaired intellectual and psychomotor functioning, 3 neuroendocrine abnormalities, 4 impaired reproductive capacity, [5][6][7][8] cardiotoxicity, 9 and second malignant neoplasms [10][11][12][13][14][15][16][17] are being reported with increased frequency in the growing cohort of survivors.…”

A Recycling Defect as a Characteristic of Natural Killer Cells in Childhood Acute Lymphoblastic Leukemia

“…Because the recycling defect is not observed in neuroblastoma treated with chemotherapy, the continued recycling defect in ALL cannot be explained by the effect of its chemotherapy alone; thus, this defect seems to be characteristic of NK cells in ALL. It is known that they have a greater risk of second malignancies, especially leukemia and lymphoma (23). On the other hand, NK cell deficiency is often associated with the development of these diseases (4, 5 , 17).…”