Leukemia after therapy with alkylating agents for childhood cancer

Journal Article · Sun Mar 01 04:00:00 EST 1987 · J. Natl. Cancer Inst.; (United States)

OSTI ID:6593681

Tucker, M A; Meadows, A T; Boice, Jr, J D; Stovall, M; Oberlin, O; Stone, B J; Birch, J; Voute, P A; Hoover, R N; Fraumeni, Jr, J F

The risk of leukemia was evaluated in 9,170 2-or-more-year survivors of childhood cancer in the 13 institutions of the Late Effects Study Group. Secondary leukemia occurred in 22 nonreferred individuals compared to 1.52 expected, based on general population rates (relative risk (RR) = 14; 95% confidence interval (CI), 9-22). The influence of therapy for the first cancer on subsequent leukemia risk was determined by a case-control study conducted on 25 cases and 90 matched controls. Treatment with alkylating agents was associated with a significantly elevated risk of leukemia (RR = 4.8; 95% CI, 1.2-18.9). A strong dose-response relationship was also observed between leukemia risk and total dose of alkylating agents, estimated by an alkylator score. The RR of leukemia reached 23 in the highest dose category. Radiation therapy, however, did not increase risk. Although doxorubicin was also identified as a possible risk factor, the excess risk of leukemia following treatment for childhood cancer appears almost entirely due to alkylating agents.

• Research Organization: National Cancer Institute, Bethesda, MD
• OSTI ID: 6593681
• Journal Information: J. Natl. Cancer Inst.; (United States), Journal Name: J. Natl. Cancer Inst.; (United States) Vol. 3; ISSN JNCIA
• Country of Publication: United States
• Language: English

Related Subjects

550600* -- Medicine
550603 -- Medicine-- External Radiation in Therapy-- (1980-)
62 RADIOLOGY AND NUCLEAR MEDICINE
AGE GROUPS
ALKYLATING AGENTS
ANTI-INFECTIVE AGENTS
ANTIBIOTICS
ANTINEOPLASTIC DRUGS
CARCINOGENESIS
CHEMOTHERAPY
CHILDREN
COMBINED THERAPY
DISEASES
DOSE-RESPONSE RELATIONSHIPS
DOXORUBICIN
DRUGS
HEMIC DISEASES
LEUKEMIA
MEDICINE
NEOPLASMS
NUCLEAR MEDICINE
PATHOGENESIS
RADIOLOGY
RADIOTHERAPY
RISK ASSESSMENT
SIDE EFFECTS
THERAPY