BACKGROUND: In a national pediatric case-control study, we observed a very high relative risk of leukemia in patients who had received continuous etoposide (CE) over 6 months or more, but we could not estimate the absolute risk. The purpose of the present study was to estimate this absolute risk after CE. PROCEDURES: We report a study of 18 patients with refractory or recurrent tumors who received CE over 6 months or more between 1995 and 1997. It was administered either 3 days a week for 3/4 weeks ("3 x 3", 14 patients) or 7 days a week for 3/4 weeks ("7 x 3", four patients). RESULTS: Five patients developed secondary leukemia 10-25 months after the initiation of CE. All the others died of their first tumor. The cumulative incidence of leukemia at 30 months was 28% (95% CI, 10%-53%). A chromosome 11q23 rearrangement was found in 3/5 cases. All four patients who received the "7 x 3" CE schedule developed leukemia compared to 1/14 treated with the "3 x 3" CE schedule (P = 0.002). CONCLUSIONS: Given its efficacy, CE may still have a place as a palliative treatment. However, the risk of leukemia must be borne in mind when considering its use in patients with a better prognosis.
BACKGROUND: In a national pediatric case-control study, we observed a very high relative risk of leukemia in patients who had received continuous etoposide (CE) over 6 months or more, but we could not estimate the absolute risk. The purpose of the present study was to estimate this absolute risk after CE. PROCEDURES: We report a study of 18 patients with refractory or recurrent tumors who received CE over 6 months or more between 1995 and 1997. It was administered either 3 days a week for 3/4 weeks ("3 x 3", 14 patients) or 7 days a week for 3/4 weeks ("7 x 3", four patients). RESULTS: Five patients developed secondary leukemia 10-25 months after the initiation of CE. All the others died of their first tumor. The cumulative incidence of leukemia at 30 months was 28% (95% CI, 10%-53%). A chromosome 11q23 rearrangement was found in 3/5 cases. All four patients who received the "7 x 3" CE schedule developed leukemia compared to 1/14 treated with the "3 x 3" CE schedule (P = 0.002). CONCLUSIONS: Given its efficacy, CE may still have a place as a palliative treatment. However, the risk of leukemia must be borne in mind when considering its use in patients with a better prognosis.
Authors: Chelsea L Collins; Peter J Bartz; David R Lal; Annette D Segura; Ronald K Woods; Richard L Tower Journal: J Pediatr Hematol Oncol Date: 2014-05 Impact factor: 1.289
Authors: Christina Peters; Michael H Albert; Anna Eichinger; Ulrike Poetschger; Evgenia Glogova; Peter Bader; Oliver Basu; Rita Beier; Birgit Burkhardt; Carl-Friedrich Classen; Alexander Claviez; Selim Corbacioglu; Hedwig E Deubzer; Johann Greil; Bernd Gruhn; Tayfun Güngör; Kinan Kafa; Jörn-Sven Kühl; Peter Lang; Bjoern Soenke Lange; Roland Meisel; Ingo Müller; Martin G Sauer; Paul-Gerhardt Schlegel; Ansgar Schulz; Daniel Stachel; Brigitte Strahm; Angela Wawer Journal: Leukemia Date: 2022-09-12 Impact factor: 12.883
Authors: Brian H Kushner; Kim Kramer; Shakeel Modak; Li-Xuan Qin; Karima Yataghena; Suresh C Jhanwar; Nai-Kong V Cheung Journal: Pediatr Blood Cancer Date: 2009-07 Impact factor: 3.167
Authors: Marta Perez-Somarriba; Maitane Andión; Miguel A López-Pino; Cinzia Lavarino; Luis Madero; Alvaro Lassaletta Journal: Childs Nerv Syst Date: 2019-02-01 Impact factor: 1.475