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Leukemia After Therapy With Alkylating Agents for Childhood Cancer2
Abstract
The risk of leukemia was evaluated in 9,170 2-or-more-year survivors of childhood cancer in the 13 institutions of the Late Effects Study Group. Secondary leukemia occurred in 22 nonreferred individuals compared to 1.52 expected, based on general population rates [relative risk (RR) = 14; 95% confidence interval (CI), 9-22]. The influence of therapy for the first cancer on subsequent leukemia risk was determined by a case-control study conducted on 25 cases and 90 matched controls. Treatment with alkylating agents was associated with a significantly elevated risk of leukemia (RR = 4.8; 95% CI, 1.2-18.9). A strong dose-response relationship was also observed between leukemia risk and total dose of alkylating agents, estimated by an alkylator score. The RR of leukemia reached 23 in the highest dose category. Radiation therapy, however, did not increase risk. Although doxorubicin was also identified as a possible risk factor, the excess risk of leukemia following treatment for childhood cancer appears almost entirely due to alkylating agents.
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Citations
Cited by
Bone Sarcomas Linked to Radiotherapy and Chemotherapy in Children
Tucker, M. A., D'Angio, G. J., Boice, J. D., Strong, L. C., Li, F. P., Stovall, M., Stone, B. J., Green, D. M., Lombardi, F., Newton, W., et al. (1987) · New England Journal of Medicine · doi:10.1056/nejm198709033171002 · Cited by 765
Self-citationSecondary Acute Myeloid Leukemia in Children Treated for Acute Lymphoid Leukemia
Pui, C.-H., Behm, F. G., Raimondi, S. C., Dodge, R. K., George, S. L., Rivera, G. K., Mirro, J., Kalwinsky, D. K., Dahl, G. V., Murphy, S. B., et al. (1989) · New England Journal of Medicine · doi:10.1056/nejm198907203210302 · Cited by 441
CANCER RISKS FROM MEDICAL RADIATION
Ron, E. (2003) · Health Physics · doi:10.1097/00004032-200307000-00011 · Cited by 382
Darrington, D. L., Vose, J. M., Anderson, J. R., Bierman, P. J., Bishop, M. R., Chan, W. C., Morris, M. E., Reed, E. C., Sanger, W. G., & Tarantolo, S. R. (1994) · Journal of Clinical Oncology · doi:10.1200/jco.1994.12.12.2527 · Cited by 332
Incidence of second primary tumours among childhood cancer survivors
Hawkins, M., Draper, G., & Kingston, J. (1987) · British Journal of Cancer · doi:10.1038/bjc.1987.200 · Cited by 332
Metadata
- Authors
- Tucker, M. A., Meadows, A. T., Boice, J. D., Stovall, M., Oberlin, O., Stone, B. J., Birch, J., Voûte, P. A., Hoover, R. N., Fraumeni, J. F., & Late Effects Study Group
- Venue
- JNCI: Journal of the National Cancer Institute
- Publisher
- Oxford University Press (OUP)
- Published
- 1987-03-01
- Volume
- 78
- Issue
- 3
- Pages
- 459-464
- ISSN
- 0027-8874 (ISSN-L)
- 1460-2105
- OpenAlex
- W2106782951
- Cited by
- 352
- References
- 0
- FWCI
- 10.64
- Type
- journal article
- Language
- en
- Open access
- closed
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- Tucker, M. A., Meadows, A. T., Boice, J. D., Stovall, M., Oberlin, O., Stone, B. J., Birch, J., Voûte, P. A., Hoover, R. N., Fraumeni, J. F., & Late Effects Study Group. (1987). Leukemia After Therapy With Alkylating Agents for Childhood Cancer2. JNCI: Journal of the National Cancer Institute. https://doi.org/10.1093/jnci/78.3.459
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
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