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Increased risk of subsequent neoplasm after hematopoietic stem cell transplantation in 5-year survivors of childhood acute lymphoblastic leukemia

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Title: Increased risk of subsequent neoplasm after hematopoietic stem cell transplantation in 5-year survivors of childhood acute lymphoblastic leukemia
Authors: Aimée S. R. Westerveld, Pien Roesthuis, Helena J. H. van der Pal, Dorine Bresters, Marc Bierings, Jacqueline Loonen, Andrica C. H. de Vries, Marloes Louwerens, Maria M. W. Koopman, Marry M. van den Heuvel-Eibrink, Margriet van der Heiden-van der Loo, Peter Hoogerbrugge, Geert O. Janssens, Ronald R. de Krijger, Cecile M. Ronckers, Rob Pieters, Leontien C. M. Kremer, Jop C. Teepen
Contributors: Cancer, MS Radiotherapie, Pathologie Pathologen staf, Zorg en O&O, Child Health
Source: Blood Cancer J
Blood Cancer Journal, Vol 14, Iss 1, Pp 1-10 (2024)
Blood Cancer Journal, 14, 1, pp. 150
Publisher Information: Springer Science and Business Media LLC, 2024.
Publication Year: 2024
Subject Terms: Male, Adult, Adolescent, Primary and Community Care - Radboud University Medical Center, Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy, Article, Young Adult, SDG 3 - Good Health and Well-being, Cancer Survivors, Risk Factors, Journal Article, Humans, Hematopoietic Stem Cell Transplantation/adverse effects, Child, Haematology - Radboud University Medical Center, RC254-282, Incidence, Hematopoietic Stem Cell Transplantation, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Infant, Neoplasms, Second Primary, Precursor Cell Lymphoblastic Leukemia-Lymphoma, 3. Good health, Child, Preschool, Neoplasms, Second Primary/epidemiology, Female, Cancer Survivors/statistics, Adolescent [MeSH], Female [MeSH], 631/67/2324, Precursor Cell Lymphoblastic Leukemia-Lymphoma/epidemiology [MeSH], 631/67/1990/283/2125, Adult [MeSH], Humans [MeSH], Incidence [MeSH], Risk Factors [MeSH], Hematopoietic Stem Cell Transplantation/adverse effects [MeSH], Neoplasms, Second Primary/epidemiology [MeSH], Infant [MeSH], Male [MeSH], 692/499, Young Adult [MeSH], Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy [MeSH], Neoplasms, Second Primary/etiology [MeSH], Child [MeSH], article, Child, Preschool [MeSH], Cancer Survivors/statistics & numerical data
Description: Acute lymphoblastic leukemia (ALL) survivors are at risk for developing subsequent neoplasms, but there is limited information on long-term risks and risk factors for both subsequent malignant neoplasms (SMNs) and subsequent non-malignant neoplasms (SNMNs). We analyzed long-term risk and risk factors for SMNs and SNMNs among 3291 5-year ALL survivors from the Dutch Childhood Cancer Survivor Study-LATER cohort (1963-2014). We calculated standardized incidence ratios (SIRs) and cumulative incidences and used multivariable Cox proportional hazard regression analyses for analyzing risk factors. A total of 97 survivors developed SMNs and 266 SNMNs. The 30-year cumulative incidence was 4.1% (95%CI: 3.5-5.3) for SMNs and 10.4%(95%CI: 8.9-12.1) for SNMNs. Risk of SMNs was elevated compared to the general population (SIR: 2.6, 95%CI: 2.1-3.1). Survivors treated with hematopoietic stem cell transplantation (HSCT) with total body irradiation (TBI) (HR:4.2, 95%CI: 2.3-7.9), and without TBI (HR:4.0,95%CI: 1.2-13.7) showed increased SMN risk versus non-transplanted survivors. Cranial radiotherapy (CRT) was also a risk factor for SMNs (HR:2.1, 95%CI: 1.4-4.0). In conclusion, childhood ALL survivors have an increased SMN risk, especially after HSCT and CRT. A key finding is that even HSCT-treated survivors without TBI treatment showed an increased SMN risk, possibly due to accompanied chemotherapy treatment. This emphasizes the need for careful follow-up of HSCT and/or CRT-treated survivors.
Document Type: Article
Other literature type
File Description: application/pdf
Language: English
ISSN: 2044-5385
DOI: 10.1038/s41408-024-01122-7
Access URL: https://pubmed.ncbi.nlm.nih.gov/39198413
https://doaj.org/article/dd1578a6e4ab4a39aa7be9fb7ad260a1
https://hdl.handle.net/https://repository.ubn.ru.nl/handle/2066/310238
https://dspace.library.uu.nl/handle/1874/455759
https://hdl.handle.net/1887/4212852
https://repository.ubn.ru.nl//bitstream/handle/2066/310238/310238.pdf
https://hdl.handle.net/2066/310238
https://repository.publisso.de/resource/frl:6507046
Rights: CC BY NC ND
Accession Number: edsair.doi.dedup.....b046e8a13f8afda2d7f79017202c40a1
Database: OpenAIRE
Description
Abstract:Acute lymphoblastic leukemia (ALL) survivors are at risk for developing subsequent neoplasms, but there is limited information on long-term risks and risk factors for both subsequent malignant neoplasms (SMNs) and subsequent non-malignant neoplasms (SNMNs). We analyzed long-term risk and risk factors for SMNs and SNMNs among 3291 5-year ALL survivors from the Dutch Childhood Cancer Survivor Study-LATER cohort (1963-2014). We calculated standardized incidence ratios (SIRs) and cumulative incidences and used multivariable Cox proportional hazard regression analyses for analyzing risk factors. A total of 97 survivors developed SMNs and 266 SNMNs. The 30-year cumulative incidence was 4.1% (95%CI: 3.5-5.3) for SMNs and 10.4%(95%CI: 8.9-12.1) for SNMNs. Risk of SMNs was elevated compared to the general population (SIR: 2.6, 95%CI: 2.1-3.1). Survivors treated with hematopoietic stem cell transplantation (HSCT) with total body irradiation (TBI) (HR:4.2, 95%CI: 2.3-7.9), and without TBI (HR:4.0,95%CI: 1.2-13.7) showed increased SMN risk versus non-transplanted survivors. Cranial radiotherapy (CRT) was also a risk factor for SMNs (HR:2.1, 95%CI: 1.4-4.0). In conclusion, childhood ALL survivors have an increased SMN risk, especially after HSCT and CRT. A key finding is that even HSCT-treated survivors without TBI treatment showed an increased SMN risk, possibly due to accompanied chemotherapy treatment. This emphasizes the need for careful follow-up of HSCT and/or CRT-treated survivors.
ISSN:20445385
DOI:10.1038/s41408-024-01122-7