Secondary cancers among children with acute lymphoblastic leukaemia treated by the Tokyo Children's Cancer Study Group protocols: a retrospective cohort study
Corresponding Author
Yasushi Ishida
Department of Paediatrics, St. Luke's International Hospital, Tokyo, Japan
Centre of Clinical Epidemiology, St. Luke's Life Science Institute, Tokyo, Japan
Correspondence: Yasushi Ishida, Department of Paediatrics, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo 104-8460, Japan.
E-mail: [email protected]
Search for more papers by this authorMiho Maeda
Department of Paediatrics, Nippon Medical School, Tokyo, Japan
Search for more papers by this authorKevin Y. Urayama
Centre of Clinical Epidemiology, St. Luke's Life Science Institute, Tokyo, Japan
School of Public Health, University of California, Berkeley, CA, USA
Search for more papers by this authorChikako Kiyotani
Division of Oncology, National Centre for Child Health and Development, Tokyo, Japan
Search for more papers by this authorYuki Aoki
Department of Paediatrics and Developmental Biology, Tokyo Medical and Dental University, Tokyo, Japan
Search for more papers by this authorYoko Kato
Department of Paediatrics, Jikei University School of Medicine, Tokyo, Japan
Search for more papers by this authorShoko Goto
Department of Paediatrics, Yokohama City University School of Medicine, Yokohama, Japan
Search for more papers by this authorSachi Sakaguchi
Department of Paediatrics and Adolescent Medicine, Juntendo University School of Medicine, Tokyo, Japan
Search for more papers by this authorKenichi Sugita
Department of Paediatrics, Dokkyo Medical University, Tochigi, Japan
Search for more papers by this authorMika Tokuyama
Department of Paediatrics, Yachimata Hospital, Chiba, Japan
Search for more papers by this authorNaoya Nakadate
Department of General Paediatrics, National Centre for Child Health and Development, Tokyo, Japan
Search for more papers by this authorEizaburo Ishii
Department of Paediatrics, Nagano Prefectural Suzaka Hospital, Nagano, Japan
Search for more papers by this authorMasahiro Tsuchida
Department of Paediatrics, Ibaraki Children's Hospital, Mito, Japan
Search for more papers by this authorAkira Ohara
First Department of Paediatrics, Toho University, Tokyo, Japan
Search for more papers by this authorThe QOL committee of Tokyo Children's Cancer Study Group (TCCSG)
Search for more papers by this authorCorresponding Author
Yasushi Ishida
Department of Paediatrics, St. Luke's International Hospital, Tokyo, Japan
Centre of Clinical Epidemiology, St. Luke's Life Science Institute, Tokyo, Japan
Correspondence: Yasushi Ishida, Department of Paediatrics, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo 104-8460, Japan.
E-mail: [email protected]
Search for more papers by this authorMiho Maeda
Department of Paediatrics, Nippon Medical School, Tokyo, Japan
Search for more papers by this authorKevin Y. Urayama
Centre of Clinical Epidemiology, St. Luke's Life Science Institute, Tokyo, Japan
School of Public Health, University of California, Berkeley, CA, USA
Search for more papers by this authorChikako Kiyotani
Division of Oncology, National Centre for Child Health and Development, Tokyo, Japan
Search for more papers by this authorYuki Aoki
Department of Paediatrics and Developmental Biology, Tokyo Medical and Dental University, Tokyo, Japan
Search for more papers by this authorYoko Kato
Department of Paediatrics, Jikei University School of Medicine, Tokyo, Japan
Search for more papers by this authorShoko Goto
Department of Paediatrics, Yokohama City University School of Medicine, Yokohama, Japan
Search for more papers by this authorSachi Sakaguchi
Department of Paediatrics and Adolescent Medicine, Juntendo University School of Medicine, Tokyo, Japan
Search for more papers by this authorKenichi Sugita
Department of Paediatrics, Dokkyo Medical University, Tochigi, Japan
Search for more papers by this authorMika Tokuyama
Department of Paediatrics, Yachimata Hospital, Chiba, Japan
Search for more papers by this authorNaoya Nakadate
Department of General Paediatrics, National Centre for Child Health and Development, Tokyo, Japan
Search for more papers by this authorEizaburo Ishii
Department of Paediatrics, Nagano Prefectural Suzaka Hospital, Nagano, Japan
Search for more papers by this authorMasahiro Tsuchida
Department of Paediatrics, Ibaraki Children's Hospital, Mito, Japan
Search for more papers by this authorAkira Ohara
First Department of Paediatrics, Toho University, Tokyo, Japan
Search for more papers by this authorThe QOL committee of Tokyo Children's Cancer Study Group (TCCSG)
Search for more papers by this authorSummary
With improvement in survival, it is important to evaluate the impact of treatment on secondary cancers in acute lymphoblastic leukaemia (ALL) survivors. A retrospective cohort study comprising 2918 children diagnosed with ALL and enrolled on Tokyo Children's Cancer Study Group (TCCSG) protocols between 1984 and 2005 was conducted to evaluate the incidence of secondary cancers and associated factors including treatment protocol, cranial irradiation and other characteristics of the primary ALL. Thirty-seven patients developed secondary cancers, including acute myeloid leukaemia (n = 11), myelodysplastic syndrome (n = 5), non-Hodgkin lymphoma (n = 2), brain tumours (n = 13) and other solid carcinomas (n = 6) within a median follow-up duration of 9·5 years. The cumulative incidence of any secondary cancers was 1·0% (95% confidence interval (CI), 0·7–1·4%) at 10 years and 2·4% (95% CI, 1·5–3·7%) at 20 years, respectively. Standardized incidence rate ratio of secondary cancers was 9·3 (95% CI, 6·5–12·8). Multivariate analyses showed an increased risk of secondary cancers associated with the recent treatment protocol and cranial irradiation. There was no evidence of a reduction in secondary cancer incidence despite marked decreases in cranial irradiation use in the recent protocols.
Supporting Information
| Filename | Description |
|---|---|
| bjh12602-sup-0001-TableS1_FigS1-2.pdfapplication/PDF, 375.8 KB | Fig. S1. Schemas of the TCCSG (Tokyo Children's Cancer Study Group) protocols. Fig. S2. Cumulative incidence of secondary cancers according to therapy of primary ALL. Table S1. Cox- regression analysis limited to per protocol group evaluating the association between select characteristics of the primary ALL diagnosis and risk of developing a secondary cancer. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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