Children with low-risk acute lymphoblastic leukemia are at highest risk of second cancers

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Children with low-risk acute lymphoblastic leukemia are at highest risk of second cancers. / Nielsen, Stine N.; Eriksson, Frank; Rosthoej, Susanne; Andersen, Mette K.; Forestier, Erik; Hasle, Henrik; Hjalgrim, Lisa L.; Aasberg, Ann; Abrahamsson, Jonas; Heyman, Mats; Jónsson, Ólafur G.; Pruunsild, Kaie; Vaitkeviciené, Goda E.; Vettenranta, Kim; Schmiegelow, Kjeld.

In: Pediatric Blood & Cancer, Vol. 64, No. 10, e26518, 10.2017, p. 1-9.

Research output: Contribution to journalJournal articleResearchpeer-review

Harvard

Nielsen, SN, Eriksson, F, Rosthoej, S, Andersen, MK, Forestier, E, Hasle, H, Hjalgrim, LL, Aasberg, A, Abrahamsson, J, Heyman, M, Jónsson, ÓG, Pruunsild, K, Vaitkeviciené, GE, Vettenranta, K & Schmiegelow, K 2017, 'Children with low-risk acute lymphoblastic leukemia are at highest risk of second cancers', Pediatric Blood & Cancer, vol. 64, no. 10, e26518, pp. 1-9. https://doi.org/10.1002/pbc.26518

APA

Nielsen, S. N., Eriksson, F., Rosthoej, S., Andersen, M. K., Forestier, E., Hasle, H., ... Schmiegelow, K. (2017). Children with low-risk acute lymphoblastic leukemia are at highest risk of second cancers. Pediatric Blood & Cancer, 64(10), 1-9. [e26518]. https://doi.org/10.1002/pbc.26518

Vancouver

Nielsen SN, Eriksson F, Rosthoej S, Andersen MK, Forestier E, Hasle H et al. Children with low-risk acute lymphoblastic leukemia are at highest risk of second cancers. Pediatric Blood & Cancer. 2017 Oct;64(10):1-9. e26518. https://doi.org/10.1002/pbc.26518

Author

Nielsen, Stine N. ; Eriksson, Frank ; Rosthoej, Susanne ; Andersen, Mette K. ; Forestier, Erik ; Hasle, Henrik ; Hjalgrim, Lisa L. ; Aasberg, Ann ; Abrahamsson, Jonas ; Heyman, Mats ; Jónsson, Ólafur G. ; Pruunsild, Kaie ; Vaitkeviciené, Goda E. ; Vettenranta, Kim ; Schmiegelow, Kjeld. / Children with low-risk acute lymphoblastic leukemia are at highest risk of second cancers. In: Pediatric Blood & Cancer. 2017 ; Vol. 64, No. 10. pp. 1-9.

Bibtex

@article{77ecce29e1a44949961c6cc7e0be401d,
title = "Children with low-risk acute lymphoblastic leukemia are at highest risk of second cancers",
abstract = "BACKGROUND: The improved survival rates for childhood acute lymphoblastic leukemia (ALL) may be jeopardized by the development of a second cancer, which has been associated with thiopurine therapy.PROCEDURE: We retrospectively analyzed three sequential Nordic Society of Paediatric Haematology and Oncology's protocols characterized by increasing intensity of thiopurine-based maintenance therapy. We explored the risk of second cancer in relation to protocols, risk group, thiopurine methyltransferase (TPMT) activity, ALL high hyperdiploidy (HeH), and t(12;21)[ETV6/RUNX1].RESULTS: After median 9.5 years (interquartile range, 5.4-15.3 yrs) of follow-up, 40 of 3,591 patients had developed a second cancer, of whom 38 had non-high-risk B-cell precursor ALL. Patients with standard-risk ALL, who received the longest maintenance therapy, had the highest adjusted hazard of second cancer (hazard ratio [HR], intermediate vs. standard risk: 0.16, 95{\%} CI: 0.06-0.43, P < 0.001; HR, high vs. standard risk: 0.09, 95{\%} CI: 0.02-0.49, P = 0.006); no significant effects of protocol, age, or white blood cell count at diagnosis, ALL HeH, or t(12;21)[ETV6/RUNX1] were observed. A subset analysis on the patients with standard-risk ALL did not show an increased hazard of second cancer from either HeH or t(12;21) (adjusted HR 2.02, 95{\%} CI: 0.69-5.96, P = 0.20). The effect of low TPMT low activity was explored in patients reaching maintenance therapy in clinical remission (n = 3,368); no association with second cancer was observed (adjusted HR 1.43, 95{\%} CI: 0.54-3.76, P = 0.47).CONCLUSIONS: The rate of second cancer was generally highest in patients with low-risk ALL, but we could not identify a subset at higher risk than others.",
keywords = "Adolescent, Antineoplastic Combined Chemotherapy Protocols, Child, Chromosomes, Human, Pair 12, Chromosomes, Human, Pair 21, Female, Follow-Up Studies, Humans, Male, Methyltransferases, Neoplasms, Second Primary, Ploidies, Precursor Cell Lymphoblastic Leukemia-Lymphoma, Retrospective Studies, Risk Factors, Translocation, Genetic, Journal Article",
author = "Nielsen, {Stine N.} and Frank Eriksson and Susanne Rosthoej and Andersen, {Mette K.} and Erik Forestier and Henrik Hasle and Hjalgrim, {Lisa L.} and Ann Aasberg and Jonas Abrahamsson and Mats Heyman and J{\'o}nsson, {{\'O}lafur G.} and Kaie Pruunsild and Vaitkevicien{\'e}, {Goda E.} and Kim Vettenranta and Kjeld Schmiegelow",
note = "{\circledC} 2017 Wiley Periodicals, Inc.",
year = "2017",
month = "10",
doi = "10.1002/pbc.26518",
language = "English",
volume = "64",
pages = "1--9",
journal = "Pediatric Blood & Cancer",
issn = "1545-5009",
publisher = "JohnWiley & Sons, Inc.",
number = "10",

}

RIS

TY - JOUR

T1 - Children with low-risk acute lymphoblastic leukemia are at highest risk of second cancers

AU - Nielsen, Stine N.

AU - Eriksson, Frank

AU - Rosthoej, Susanne

AU - Andersen, Mette K.

AU - Forestier, Erik

AU - Hasle, Henrik

AU - Hjalgrim, Lisa L.

AU - Aasberg, Ann

AU - Abrahamsson, Jonas

AU - Heyman, Mats

AU - Jónsson, Ólafur G.

AU - Pruunsild, Kaie

AU - Vaitkeviciené, Goda E.

AU - Vettenranta, Kim

AU - Schmiegelow, Kjeld

N1 - © 2017 Wiley Periodicals, Inc.

PY - 2017/10

Y1 - 2017/10

N2 - BACKGROUND: The improved survival rates for childhood acute lymphoblastic leukemia (ALL) may be jeopardized by the development of a second cancer, which has been associated with thiopurine therapy.PROCEDURE: We retrospectively analyzed three sequential Nordic Society of Paediatric Haematology and Oncology's protocols characterized by increasing intensity of thiopurine-based maintenance therapy. We explored the risk of second cancer in relation to protocols, risk group, thiopurine methyltransferase (TPMT) activity, ALL high hyperdiploidy (HeH), and t(12;21)[ETV6/RUNX1].RESULTS: After median 9.5 years (interquartile range, 5.4-15.3 yrs) of follow-up, 40 of 3,591 patients had developed a second cancer, of whom 38 had non-high-risk B-cell precursor ALL. Patients with standard-risk ALL, who received the longest maintenance therapy, had the highest adjusted hazard of second cancer (hazard ratio [HR], intermediate vs. standard risk: 0.16, 95% CI: 0.06-0.43, P < 0.001; HR, high vs. standard risk: 0.09, 95% CI: 0.02-0.49, P = 0.006); no significant effects of protocol, age, or white blood cell count at diagnosis, ALL HeH, or t(12;21)[ETV6/RUNX1] were observed. A subset analysis on the patients with standard-risk ALL did not show an increased hazard of second cancer from either HeH or t(12;21) (adjusted HR 2.02, 95% CI: 0.69-5.96, P = 0.20). The effect of low TPMT low activity was explored in patients reaching maintenance therapy in clinical remission (n = 3,368); no association with second cancer was observed (adjusted HR 1.43, 95% CI: 0.54-3.76, P = 0.47).CONCLUSIONS: The rate of second cancer was generally highest in patients with low-risk ALL, but we could not identify a subset at higher risk than others.

AB - BACKGROUND: The improved survival rates for childhood acute lymphoblastic leukemia (ALL) may be jeopardized by the development of a second cancer, which has been associated with thiopurine therapy.PROCEDURE: We retrospectively analyzed three sequential Nordic Society of Paediatric Haematology and Oncology's protocols characterized by increasing intensity of thiopurine-based maintenance therapy. We explored the risk of second cancer in relation to protocols, risk group, thiopurine methyltransferase (TPMT) activity, ALL high hyperdiploidy (HeH), and t(12;21)[ETV6/RUNX1].RESULTS: After median 9.5 years (interquartile range, 5.4-15.3 yrs) of follow-up, 40 of 3,591 patients had developed a second cancer, of whom 38 had non-high-risk B-cell precursor ALL. Patients with standard-risk ALL, who received the longest maintenance therapy, had the highest adjusted hazard of second cancer (hazard ratio [HR], intermediate vs. standard risk: 0.16, 95% CI: 0.06-0.43, P < 0.001; HR, high vs. standard risk: 0.09, 95% CI: 0.02-0.49, P = 0.006); no significant effects of protocol, age, or white blood cell count at diagnosis, ALL HeH, or t(12;21)[ETV6/RUNX1] were observed. A subset analysis on the patients with standard-risk ALL did not show an increased hazard of second cancer from either HeH or t(12;21) (adjusted HR 2.02, 95% CI: 0.69-5.96, P = 0.20). The effect of low TPMT low activity was explored in patients reaching maintenance therapy in clinical remission (n = 3,368); no association with second cancer was observed (adjusted HR 1.43, 95% CI: 0.54-3.76, P = 0.47).CONCLUSIONS: The rate of second cancer was generally highest in patients with low-risk ALL, but we could not identify a subset at higher risk than others.

KW - Adolescent

KW - Antineoplastic Combined Chemotherapy Protocols

KW - Child

KW - Chromosomes, Human, Pair 12

KW - Chromosomes, Human, Pair 21

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Male

KW - Methyltransferases

KW - Neoplasms, Second Primary

KW - Ploidies

KW - Precursor Cell Lymphoblastic Leukemia-Lymphoma

KW - Retrospective Studies

KW - Risk Factors

KW - Translocation, Genetic

KW - Journal Article

U2 - 10.1002/pbc.26518

DO - 10.1002/pbc.26518

M3 - Journal article

VL - 64

SP - 1

EP - 9

JO - Pediatric Blood & Cancer

JF - Pediatric Blood & Cancer

SN - 1545-5009

IS - 10

M1 - e26518

ER -

ID: 184633904