Secondary acute myeloid leukemia in children treated for acute lymphoid leukemia

Article Abstract:

Leukemia is cancer of the disease-fighting white blood cells. The risk of the development of acute myeloid leukemia (AML), a cancer of the bone marrow where blood cells are made, during initial remission was studied in 730 children who were being treated with chemotherapy for acute lymphoid leukemia (ALL), a disease of the lymph system, which returns white cells to the blood from where they have been working. Three years after diagnosis, 1.5 percent of the children had developed AML; six years after diagnosis, 4.5 percent of the children had developed the bone marrow disease. AML was more likely to develop in patients with T-cell rather than non-T-cell immune systems. The presence of cells with previously unseen genetic codes suggested that a new tumor had formed in nine patients. In the immature blood cells of eight patients, there were genetic abnormalities associated with malignancy upon maturity. Genetic abnormalities usually occur in patients with AML who are treated with radiation or alkylating drugs. Patients receiving intensive treatment for ALL have a significant risk of AML, especially if they have T-cell immune systems. Certain genetic abnormalities associated with blood cells becoming malignant may be important in the development of this disease.

Health aspects, Causes of, Hodgkin's disease, Pediatric diseases, Drug therapy, Antineoplastic agents, Leukemia, Myeloblastic leukemia, Human cytogenetics, Hodgkin's disease in children, Alkylating agents

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Low leukocyte counts with blast cells in cerebrospinal fluid of children with newly diagnosed acute lymphoblastic leukemia

Article Abstract:

Children with central nervous system leukemia who have immature blood cells (blasts) in their cerebrospinal fluid but few white blood cells may require intensive chemotherapy and radiation therapy. This contradicts the present policy, which recommends intensive therapy only for those with more than five white blood cells per microliter of cerebrospinal fluid. Of 351 children with acute lymphoblastic leukemia affecting the central nervous system, 291 had no evidence of blasts in their cerebrospinal fluid, 42 had blasts but fewer than five white blood cells per microliter and 18 had blasts and more than five white blood cells per microliter. All the children received chemotherapy for one year and those at high risk of relapse received chemotherapy and radiation treatment one year after remission. Five-year survival rates were similar in the two groups that had blasts in their cerebrospinal fluid, regardless of the level of white blood cells. Nine of these children experienced a relapse, all within the first year of therapy. Five had fewer than five white blood cells per microliter of cerebrospinal fluid.

Diagnosis, Lymphoblastic leukemia in children, Childhood leukemia, Cerebrospinal fluid

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Extended follow-up of long-term survivors of childhood acute lymphoblastic leukemia

Article Abstract:

Children with acute lymphoblastic leukemia may have a better long-term prognosis if they do not receive radiation treatment, according to a study of 856 patients who were treated between 1962 and 1992. Those who had radiation treatment had higher mortality rates and a higher risk of developing a second cancer sometime during their life. They were also more likely to be unemployed and less likely to be married than patients who did not receive radiation treatment.

Patient outcomes, Prognosis, Cancer in children, Childhood cancer, Radiotherapy

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