Poyer Fiona, Dieckmann Karin, Dworzak Michael, Tamesberger Melanie, Haas Oskar, Jones Neil, Nebral Karin, Köhrer Stefan, Moser Reinhard, Kropshofer Gabriele, Peters Christina, Urban Christian, Mann Georg, Pötschger Ulrike, Attarbaschi Andishe
Department of Pediatric Hematology and Oncology, St. Anna Children's Hospital Medical University of Vienna Vienna Austria.
Department of Radiotherapy Medical University of Vienna Vienna Austria.
EJHaem. 2022 Jun 12;3(3):940-948. doi: 10.1002/jha2.488. eCollection 2022 Aug.
Second malignant neoplasms (SMN) after primary childhood acute lymphoblastic leukemia (ALL) are rare. Among 1487 ALL patients diagnosed between 1981 and 2010 in Austria, the 10-year cumulative incidence of an SMN was 1.1% ± 0.3%. There was no difference in the 10-year incidence of SMNs with regard to diagnostic-, response- and therapy-related ALL characteristics except for a significantly higher incidence in patients with leukocytes ≥50.0 G/L at ALL diagnosis (2.1% ± 1.0% vs. 0% for 20.0-50.0 G/L, and 1.0% ± 0.3% for < 20.0 G/L; = 0.033). Notably, there was no significant difference in the incidence of SMNs between patients with or without cranial radiotherapy (1.2% ± 0.5% vs. 0.8% ± 0.3%; = 0.295). Future strategies must decrease the incidence of SMNs, as this event still leads to death in one-third (7/19) of the patients.
儿童原发性急性淋巴细胞白血病（ALL）后的第二原发性恶性肿瘤（SMN）较为罕见。在1981年至2010年间于奥地利确诊的1487例ALL患者中，SMN的10年累积发病率为1.1%±0.3%。除了ALL诊断时白细胞≥50.0 G/L的患者中SMN的发病率显著更高（2.1%±1.0%，而白细胞在20.0 - 50.0 G/L的患者为0%，白细胞<20.0 G/L的患者为1.0%±0.3%；P = 0.033）外，SMN的10年发病率在与诊断、反应和治疗相关的ALL特征方面没有差异。值得注意的是，接受或未接受颅脑放疗的患者中SMN的发病率没有显著差异（1.2%±0.5%对0.8%±0.3%；P = 0.295）。未来的策略必须降低SMN的发病率，因为这一事件仍导致三分之一（7/19）的患者死亡。
