Results from the longest follow-up study ever done of childhood acute lymphoblastic leukemia (ALL) survivors show the importance of long-term monitoring of former patients to identify complications they are at risk for developing later in life and to modify current treatments to reduce those risks, according to investigators at St. Jude Children's Research Hospital. ALL is the most common cancer in children and adolescentswith about 3,000 new cases diagnosed yearly in the United States.
The St. Jude study showed that adults who had received treatment for ALL during childhood are at increased risk for developing a secondary neoplasm during the next 30 years. Secondary neoplasms are new tumors that develop after successful treatment of an initial cancer.
A report on this work appears in the March 21 issue of the "Journal of the American Medical Association" ("JAMA").
The finding is important because the cure rate of children treated for ALL has increased dramatically since the 1960s, approaching 90 percent today at St. Jude. Therefore, it is important to monitor survivors during their entire lives to identify the long-term complications they might experience even decades after the end of their treatment, the researchers said.
Previous studies found a relatively low incidence of secondary neoplasm during the first 10 to 15 years after treatment for ALL. Those studies suggested that the incidence of these new tumors might not be significant 20 years after therapy. "On the contrary, our longer study shows that after 20 years the incidence continues to increase," said Nobuko Hijiya, M.D., assistant member in the St. Jude Oncology department. Hijiya is the first and corresponding author of the "JAMA" article.
The St. Jude study found that most of these late-onset secondary neoplasms are low-grade, or slow-growing, tumors that are curablespecifically, meningiomas (tumors arising from the membranes covering the brain) a
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St. Jude Children's Research Hospital