Drugie nowotwory u dzieci po ostrej białaczce limfoblastycznej

*Edyta Sowińska¹, Karolina Gawle¹, Magdalena Wojtkowska¹, Katarzyna Pawelec²

Summary
Aim. Second malignant neoplasm (SMN) is a serious complication after treatment of childhood cancers. Intensive chemotherapy, radiation therapy, genetic predisposition and their interactions have been identified as main risk factors for develiping SMN. Acute lymphoblastic leukaemia is the most common childhood malignancy. In this article we analyzed the risk factors associated with developing SMN in children with ALL
Material and methods. This study is retrospective. We analyzed the medical documents 789 children treated for ALL between 1987 and 2006, comparing our results to data presented in other studies and publications.
Results. In observed group of patients, 10 developed SMN (7 female patients, 3 male patients). Their average age at diagnosis of ALL was 3 years and 11 months (median 3 years and 9.5 months). SMN occured an average of 9 years and 5 months from original diagnosis (median 9 years and 4 months). All children had been treated with chemotherapeutic agents: inhibitors of topoisomerase-II, alkylating agents, anthracyclines. 9 of the 10 patients received radiotherapy. Hematopoietic stem cell transplantation (HSCT) was performed in two cases. CNS tumors represented the most common subtype of SMN, occuring in 6 patients. Other diagnosis of SMNs included one case of: AML, thyroid carcinoma, hepatocellular carcinoma and basal cell carcinoma. 4 children have died from the SMN.
Conclusion. SMN developed were more common in female patients and among the younger patients at diagnosis of ALL. The cumulative risk of SMN has increased with time after the ALL treatment.

To jest tylko fragment artykułu. Aby przeczytać całość, przejdź do Czytelni medycznej.