Adverse events common years after childhood leukemia treatment

Relapses and second malignancies are relatively frequent in the years following completion of treatment for childhood acute lymphoblastic leukemia (ALL), according to a report in the November 1st Journal of Clinical Oncology.

“To further advance the cure rate,” Dr. Ching-Hon Pui from St. Jude Children’s Research Hospital, Memphis, Tennessee told Reuters Health, “one must design treatment regimens that not only decrease the rate of leukemic relapse but also decrease the rate of development of second cancer.”As part of that effort, Dr. Pui and colleagues evaluated the frequency, causes, and predictors of adverse events in 827 children with ALL who had completed treatment on contemporary clinical protocols between 1984 and 1999. The overall event-free survival rate was 86.0% at five years and 83.1% at 10 years after completion of treatment, the authors report. The most common cause of failure was bone marrow relapse, followed by the development of a second malignancy. Being male was the only independent adverse prognostic factor for relapse. Being under the age of 1 year or being more than 10 years old, and having a high baseline leukocyte was associated with an increased risk of second malignancy. “Partly because of the reduction in leukemic relapses,” the investigators observe, “second malignancies have become a major cause of treatment failure, accounting for almost a third of the adverse events in patients treated at our centers in the mid-1980s.”Dr. Pui added that despite earlier findings, current treatment “appears to abolish the adverse prognostic impact of male sex. Boys are doing just as well as girls.”(Source: J Clin Oncol 2005;23:7936-7941: Reuters Health: Oncolink: December 2005.)