Nonleukaemic second malignancies following childhood acute lymphocytic leukaemia. A report of 19 cases from the Federal Republic of Germany.

Nineteen second malignant neoplasms (SMN)2 occurring after successful treatment of childhood acute lymphoblastic leukaemia (ALL) are reported from the Federal Republic of Germany. Eighteen children were diagnosed as having ALL within a ten-year period, in which the total number of newly diagnosed ALL was about 5600 in this country. The incidence of a SMN following childhood ALL is calculated to be 2% after a 4-14 years' follow-up period. Of the 19 SMN, 7 are Hodgkin's disease, 1 malignant histiocytosis, 3 thyroid carcinomas, 3 brain tumours, and 5 other solid neoplasms. Second leukaemias were not observed. Immunoregulatory dysfunction, genetic influences and irradiation are the factors which have etiologically been discussed. Chemotherapy seems not to play a major role in the development of SMN after ALL.