High cumulative rate of secondary leukemia after continuous etoposide treatment for solid tumors in children and young adults.

Abstract:

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.

journal_name

Pediatr Blood Cancer

journal_title

Pediatric blood & cancer

authors

Le Deley MC,Vassal G,Taïbi A,Shamsaldin A,Leblanc T,Hartmann O

doi

10.1002/pbc.20380

keywords:

subject

Has Abstract

pub_date

2005-07-01 00:00:00

pages

25-31

issue

1

eissn

1545-5009

issn

1545-5017

journal_volume

45

pub_type

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