BACKGROUND: Most prior studies evaluating subsequent malignant neoplasms (SMNs) in patients with neuroblastoma are restricted to long-term survivors and/or their treatment exposures. This study investigates SMNs in patients diagnosed with neuroblastoma at our institution. METHODS: Records of 646 patients treated for neuroblastoma at St Jude Children's Research Hospital between 1961 and 2005 were reviewed. Data from patients with SMNs were analyzed and the 20- and 30-year cumulative incidence of SMNs and standardized incidence ratio were calculated. RESULTS: Twenty-one patients had a SMN. The 20- and 30-year cumulative incidences of a SMN were 2.6%±0.7% and 4.6%±1.1%, respectively. The standardized incidence ratio was 8.3 (95% confidence interval, 5.0-13.0). Five patients developed a SMN within 5 years from diagnosis. The median latency for the development of acute myeloid leukemia/myelodysplastic syndrome (n=4), sarcomas (n=7), and carcinomas (n=5) were 3.6, 9, and 24.2 years, respectively. Nine patients died from their SMN, including all with acute myeloid leukemia/myelodysplastic syndrome. CONCLUSIONS: Patients with neuroblastoma have an increased risk of secondary neoplasia. Modification of risk-adapted therapies will likely alter the affected patient population and the incidence of SMNs. Future studies are necessary to link SMNs to treatment exposures and to evaluate the risk of SMNs beyond 30 years from diagnosis.
BACKGROUND: Most prior studies evaluating subsequent malignant neoplasms (SMNs) in patients with neuroblastoma are restricted to long-term survivors and/or their treatment exposures. This study investigates SMNs in patients diagnosed with neuroblastoma at our institution. METHODS: Records of 646 patients treated for neuroblastoma at St Jude Children's Research Hospital between 1961 and 2005 were reviewed. Data from patients with SMNs were analyzed and the 20- and 30-year cumulative incidence of SMNs and standardized incidence ratio were calculated. RESULTS: Twenty-one patients had a SMN. The 20- and 30-year cumulative incidences of a SMN were 2.6%±0.7% and 4.6%±1.1%, respectively. The standardized incidence ratio was 8.3 (95% confidence interval, 5.0-13.0). Five patients developed a SMN within 5 years from diagnosis. The median latency for the development of acute myeloid leukemia/myelodysplastic syndrome (n=4), sarcomas (n=7), and carcinomas (n=5) were 3.6, 9, and 24.2 years, respectively. Nine patients died from their SMN, including all with acute myeloid leukemia/myelodysplastic syndrome. CONCLUSIONS:Patients with neuroblastoma have an increased risk of secondary neoplasia. Modification of risk-adapted therapies will likely alter the affected patient population and the incidence of SMNs. Future studies are necessary to link SMNs to treatment exposures and to evaluate the risk of SMNs beyond 30 years from diagnosis.
Authors: M A Smith; L Rubinstein; J R Anderson; D Arthur; P J Catalano; B Freidlin; R Heyn; A Khayat; M Krailo; V J Land; J Miser; J Shuster; D Vena Journal: J Clin Oncol Date: 1999-02 Impact factor: 44.544
Authors: C H Pui; R C Ribeiro; M L Hancock; G K Rivera; W E Evans; S C Raimondi; D R Head; F G Behm; M H Mahmoud; J T Sandlund Journal: N Engl J Med Date: 1991-12-12 Impact factor: 91.245
Authors: L C Bowman; M L Hancock; V M Santana; F A Hayes; L Kun; D M Parham; W L Furman; B N Rao; A A Green; W M Crist Journal: J Clin Oncol Date: 1991-09 Impact factor: 44.544
Authors: Jean S Lee; Benjamin Padilla; Steven G DuBois; Aris Oates; John Boscardin; Robert E Goldsby Journal: Pediatr Blood Cancer Date: 2015-03-25 Impact factor: 3.167
Authors: Mark A Applebaum; Tara O Henderson; Sang Mee Lee; Navin Pinto; Samuel L Volchenboum; Susan L Cohn Journal: Pediatr Blood Cancer Date: 2014-09-23 Impact factor: 3.167
Authors: Mark A Applebaum; Zalman Vaksman; Sang Mee Lee; Eric A Hungate; Tara O Henderson; Wendy B London; Navin Pinto; Samuel L Volchenboum; Julie R Park; Arlene Naranjo; Barbara Hero; Andrew D Pearson; Barbara E Stranger; Susan L Cohn; Sharon J Diskin Journal: Eur J Cancer Date: 2016-12-26 Impact factor: 9.162
Authors: Kelly E Huibregtse; Kieuhoa T Vo; Steven G DuBois; Stephanie Fetzko; John Neuhaus; Vandana Batra; John M Maris; Brian Weiss; Araz Marachelian; Greg A Yanik; Katherine K Matthay Journal: Eur J Cancer Date: 2016-08-27 Impact factor: 9.162
Authors: Sara M Federico; Samuel L Brady; Alberto Pappo; Jianrong Wu; Shenghua Mao; Valerie J McPherson; Alison Young; Wayne L Furman; Robert Kaufman; Sue Kaste Journal: Pediatr Blood Cancer Date: 2015-01-13 Impact factor: 3.167