Subsequent malignant neoplasms in pediatric patients initially diagnosed with neuroblastoma
Most prior studies evaluating subsequent malignant neoplasms (SMNs) in patients with neuroblastoma are restricted to long-term survivors and/or their treatment exposures. This study investigates SMNs in patients diagnosed with neuroblastoma at our institution. Records of 646 patients treated for neu...
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| Published in: | Journal of pediatric hematology/oncology Vol. 37; no. 1; pp. e6 - e12 |
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| Main Authors: | , , , , , , , , , |
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01-01-2015
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| Abstract | Most prior studies evaluating subsequent malignant neoplasms (SMNs) in patients with neuroblastoma are restricted to long-term survivors and/or their treatment exposures. This study investigates SMNs in patients diagnosed with neuroblastoma at our institution.
Records of 646 patients treated for neuroblastoma at St Jude Children's Research Hospital between 1961 and 2005 were reviewed. Data from patients with SMNs were analyzed and the 20- and 30-year cumulative incidence of SMNs and standardized incidence ratio were calculated.
Twenty-one patients had a SMN. The 20- and 30-year cumulative incidences of a SMN were 2.6%±0.7% and 4.6%±1.1%, respectively. The standardized incidence ratio was 8.3 (95% confidence interval, 5.0-13.0). Five patients developed a SMN within 5 years from diagnosis. The median latency for the development of acute myeloid leukemia/myelodysplastic syndrome (n=4), sarcomas (n=7), and carcinomas (n=5) were 3.6, 9, and 24.2 years, respectively. Nine patients died from their SMN, including all with acute myeloid leukemia/myelodysplastic syndrome.
Patients with neuroblastoma have an increased risk of secondary neoplasia. Modification of risk-adapted therapies will likely alter the affected patient population and the incidence of SMNs. Future studies are necessary to link SMNs to treatment exposures and to evaluate the risk of SMNs beyond 30 years from diagnosis. |
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| AbstractList | BACKGROUNDMost prior studies evaluating subsequent malignant neoplasms (SMNs) in patients with neuroblastoma are restricted to long-term survivors and/or their treatment exposures. This study investigates SMNs in patients diagnosed with neuroblastoma at our institution. METHODSRecords of 646 patients treated for neuroblastoma at St Jude Children's Research Hospital between 1961 and 2005 were reviewed. Data from patients with SMNs were analyzed and the 20- and 30-year cumulative incidence of SMNs and standardized incidence ratio were calculated. RESULTSTwenty-one patients had a SMN. The 20- and 30-year cumulative incidences of a SMN were 2.6%±0.7% and 4.6%±1.1%, respectively. The standardized incidence ratio was 8.3 (95% confidence interval, 5.0-13.0). Five patients developed a SMN within 5 years from diagnosis. The median latency for the development of acute myeloid leukemia/myelodysplastic syndrome (n=4), sarcomas (n=7), and carcinomas (n=5) were 3.6, 9, and 24.2 years, respectively. Nine patients died from their SMN, including all with acute myeloid leukemia/myelodysplastic syndrome. CONCLUSIONSPatients with neuroblastoma have an increased risk of secondary neoplasia. Modification of risk-adapted therapies will likely alter the affected patient population and the incidence of SMNs. Future studies are necessary to link SMNs to treatment exposures and to evaluate the risk of SMNs beyond 30 years from diagnosis. Most prior studies evaluating subsequent malignant neoplasms (SMNs) in patients with neuroblastoma are restricted to long-term survivors and/or their treatment exposures. This study investigates SMNs in patients diagnosed with neuroblastoma at our institution. Records of 646 patients treated for neuroblastoma at St Jude Children's Research Hospital between 1961 and 2005 were reviewed. Data from patients with SMNs were analyzed and the 20- and 30-year cumulative incidence of SMNs and standardized incidence ratio were calculated. Twenty-one patients had a SMN. The 20- and 30-year cumulative incidences of a SMN were 2.6%±0.7% and 4.6%±1.1%, respectively. The standardized incidence ratio was 8.3 (95% confidence interval, 5.0-13.0). Five patients developed a SMN within 5 years from diagnosis. The median latency for the development of acute myeloid leukemia/myelodysplastic syndrome (n=4), sarcomas (n=7), and carcinomas (n=5) were 3.6, 9, and 24.2 years, respectively. Nine patients died from their SMN, including all with acute myeloid leukemia/myelodysplastic syndrome. Patients with neuroblastoma have an increased risk of secondary neoplasia. Modification of risk-adapted therapies will likely alter the affected patient population and the incidence of SMNs. Future studies are necessary to link SMNs to treatment exposures and to evaluate the risk of SMNs beyond 30 years from diagnosis. |
| Author | Santana, Victor M Spunt, Sheri L Wu, Jianrong Billups, Catherine A Hudson, Melissa M Jenkins, Jesse McGregor, Lisa M Allewelt, Heather B Federico, Sara M Furman, Wayne L |
| AuthorAffiliation | 1 Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN 4 Department of Pediatrics, University of Tennessee Health Sciences Center, Memphis, TN 5 Department of Oncology, Duke University, Durham, NC 2 Department of Biostatistics, St. Jude Children’s Research Hospital, Memphis, TN 3 Department of Pathology, St. Jude Children’s Research Hospital, Memphis, TN |
| AuthorAffiliation_xml | – name: 2 Department of Biostatistics, St. Jude Children’s Research Hospital, Memphis, TN – name: 1 Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN – name: 5 Department of Oncology, Duke University, Durham, NC – name: 3 Department of Pathology, St. Jude Children’s Research Hospital, Memphis, TN – name: 4 Department of Pediatrics, University of Tennessee Health Sciences Center, Memphis, TN |
| Author_xml | – sequence: 1 givenname: Sara M surname: Federico fullname: Federico, Sara M organization: Departments of Oncology §Biostatistics ∥Pathology, St Jude Children's Research Hospital †Department of Pediatrics, University of Tennessee Health Sciences Center, Memphis, TN ‡Department of Oncology, Duke University, Durham, NC – sequence: 2 givenname: Heather B surname: Allewelt fullname: Allewelt, Heather B – sequence: 3 givenname: Sheri L surname: Spunt fullname: Spunt, Sheri L – sequence: 4 givenname: Melissa M surname: Hudson fullname: Hudson, Melissa M – sequence: 5 givenname: Jianrong surname: Wu fullname: Wu, Jianrong – sequence: 6 givenname: Catherine A surname: Billups fullname: Billups, Catherine A – sequence: 7 givenname: Jesse surname: Jenkins fullname: Jenkins, Jesse – sequence: 8 givenname: Victor M surname: Santana fullname: Santana, Victor M – sequence: 9 givenname: Wayne L surname: Furman fullname: Furman, Wayne L – sequence: 10 givenname: Lisa M surname: McGregor fullname: McGregor, Lisa M |
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| Snippet | Most prior studies evaluating subsequent malignant neoplasms (SMNs) in patients with neuroblastoma are restricted to long-term survivors and/or their treatment... BACKGROUNDMost prior studies evaluating subsequent malignant neoplasms (SMNs) in patients with neuroblastoma are restricted to long-term survivors and/or their... |
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| SubjectTerms | Adolescent Adult Child Child, Preschool Female Humans Incidence Infant Infant, Newborn Male Neoplasms, Second Primary - epidemiology Neoplasms, Second Primary - etiology Neuroblastoma - complications Risk |
| Title | Subsequent malignant neoplasms in pediatric patients initially diagnosed with neuroblastoma |
| URI | https://www.ncbi.nlm.nih.gov/pubmed/24633303 https://search.proquest.com/docview/1639493316 https://pubmed.ncbi.nlm.nih.gov/PMC4266626 |
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