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The study included 856 patients treated between 1962 and 1992. Among these patients, 56 had major adverse events, including eight deaths in remission (not due to cancer recurrence), four relapses of the cancer and 44 second tumors (ones that occur after successful treatment for ALL). A total of 41 of the tumors were related to radiation therapy, and most were benign (non-cancerous) growths or cancers that were not aggressive. The risk for developing a second tumor was significantly higher in the 597 irradiated patients, compared with the 259 non-irradiated patients.

Second tumors continue to develop in patients who had received radiation to the head or head and spinal region even 20 years after their initial treatment of childhood ALL, according to Pui. This finding was new because survivors of other studies were followed for an average of only 4.6 to 7.6 years.

Most of these late-onset tumors in the St. Jude survey, however, were either benign or were relatively easily treatable, for example, thyroid cancer and basal cell carcinoma (a common form of skin cancer). Thus, the rate of death for the patients who developed second tumors was relatively low (12 deaths among 44 patients).This contrasts with the high mortality rate among patients with early-onset second tumors (ones that developed within 10 years of the diagnosis of ALL) in other studies.

"That reflects the more aggressive nature of the earlier-onset tumors," Hudson said.

The higher unemployment rates for patients who had received radiation treatment for ALL, and lower marital rates among irradiated females occurred despite the relatively low radiation doses used. The effect on women may reflect hormonal problems caused by radiation--which interferes with growth and body development--as well as cognitive problems that interfere with social and emotional d
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Contact: Bonnie Cameron
bonnie.cameron@stjude.org
901-495-4815
St. Jude Children's Research Hospital
13-Aug-2003