Adverse Events Common After Childhood Leukemia

NEW YORK (Reuters Health) - Relapses and second malignancies are relatively frequent in the years following completion of treatment for childhood acute lymphoblastic leukemia (ALL), according to the results of a new study.

New treatment regimens must "not only decrease the rate of leukemic relapse but also decrease the rate of development of second cancer," Dr. Ching-Hon Pui from St. Jude Children's Research Hospital, Memphis, Tennessee told Reuters Health.

Pui and colleagues evaluated the frequency, causes, and predictors of adverse events in 827 children with ALL who had completed treatment with the latest drug regimins between 1984 and 1999.

The overall event-free survival rate was 86.0 percent at five years and 83.1 percent 10 years after treatment was finished, the authors report in the Journal of Clinical Oncology.

The most common cause of treatment failure was bone marrow relapse, followed by the development of a second malignancy.

Being male was the only independent adverse predictor for relapse. Being under the age of 1 year or being more than 10 years old, and having a high white cell count at diagnosis was associated with an increased risk of second malignancy.

"Partly because of the reduction in leukemic relapses," the investigators write, "second malignancies have become a major cause of treatment failure, accounting for almost a third of the adverse events in patients treated at our centers in the mid-1980s."

Pui added that despite earlier findings, current treatments appear to be able to eliminate the adverse impact of male sex. "Boys are doing just as well as girls."

SOURCE: Journal of Clinical Oncology, November 1, 2005.