Korean J Pediatr Hematol Oncol.
1998 Apr;5(1):113-121.
A Multicenter Clinical Study on Second Malignancies after Treatment of Childhood Cancer
- Affiliations
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- 1Department of Pediatrics, University of Ulsan College of Medicine, Korea.
- 2Department of Pediatrics, Seoul National University College of Medicine, Korea.
- 3Department of Pediatrics, Yonsei University College of Medicine, Korea.
- 4Department of Pediatrics, Kyung-Pook University School of Medicine, Korea.
- 5Department of Pediatrics, Kosin University College of Medicine, Korea.
- 6Department of Pediatrics, Catholic University Medical College, Korea.
Abstract
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BACKGROUND: This study was undertaken to investigate the frequency, causes, and outcome of second malignancies(SM) following treatment of childhood cancer in Korea.
METHODS
The Korean Society of Pediatric Hematology-Oncology(KSPHO) reviewed the records of patients who developed SM during the period of 1981-1997 through nationwide search.
RESULTS
Twenty four cases were collected, among which 7 AML, 5 osteosarcoma and 5 ALL were observed. Fifteen of them were boys, and 9 girls (1.7:1). Familial cancer was registered in 5 cases among direct relatives. No interrelationship between first and SM was observed except in 2 retinoblastoma patients who developed osteosarcoma. The SM developed in a period of 8 to 144 months (mean:55 months) after the initiation of treatment for the first malignancy. Sixteen cases had radiotherapy for the first malignancy, and in 6 of them the SM developed in the irradiated area. Fifteen patients were treated with alkylating agents, 12 received anthracyclines and 7 received etoposide. They survived 1 to 110 months (mean:15 months) after development of the SM. Sixteen patients are dead, 3 currently free of disease, and 5 alive with disease.
CONCLUSION
AML, osteosarcoma and ALL were most prevalent SM in Korean children. The mean latent period was 55 months, and showed poor mean survival period of 15 months. Radiotherapy seems to be a significant risk factor for the development of SM, but more cases are needed to assess the actual risk of certain chemotherapeutic agent. For this purpose, KSPHO continues to collect the cases of SM and to follow up the registered patients.