TY - JOUR
T1 - Increased risk of secondary leukemia after single-agent treatment with etoposide for langerhans' cell hlstlocytosls
AU - Haupt, Riccardo
AU - Fears, Thomas R.
AU - Rosso, Paolo
AU - Colella, Roberto
AU - Loiacono, Ciuseppe
AU - de Terlizzi, Marino
AU - Mancini, Antonia
AU - Comelli, Adele
AU - Indolfi, Paolo
AU - Donfrancesco, Alberto
AU - Operamolla, Patrizia
AU - Graria, Giuseppe
AU - Ceci, Adriana
AU - Tucker, Margaret A.
PY - 1994
Y1 - 1994
N2 - The study evaluated 139 patients diagnosed with Langerhans' cell histiocytosis (LCH) and enrolled in any protocol of the Italian Association of Pediatric Hematology/Oncology since 1982, Treatment was etoposide (VP-16) only in 50 patients, VP-16 and other drugs with an already established bukemogenic effect in 17 patients, only drugs with leukemogenic effect in 6 patients, other drugs in 35 patients, and surgery only in 31 patients. Median length of follow-up after diagnosis was 65 months (range, 1 to 126 months) for a total of 742.5 person-years at risk (PYRs). Three cases of acute myelogenous leukemia (AML) were reported; only 0.0044 case was expected. The standard incidence ratio (SIR) of AML in this cohort was 680.5 [95% confidence interval (CI), 140.2-1988.5], and the incidence rate per 1000 PYRs was 4.0 (95% CI, 0.8-11.8). For the subgroup treated with single-agent VP-16, the SIR after treatment was 2270.0 (95% CI, 275-8199), and the incidence rate after treatment was 14.7 (95% CI, 1.8-42.8). The study confirms a higher risk of leukemia after LCH and supports the hypothesis of an association between treatment-related acute nonlymphocytic leukemia and single-agent treatment with VP-16.
AB - The study evaluated 139 patients diagnosed with Langerhans' cell histiocytosis (LCH) and enrolled in any protocol of the Italian Association of Pediatric Hematology/Oncology since 1982, Treatment was etoposide (VP-16) only in 50 patients, VP-16 and other drugs with an already established bukemogenic effect in 17 patients, only drugs with leukemogenic effect in 6 patients, other drugs in 35 patients, and surgery only in 31 patients. Median length of follow-up after diagnosis was 65 months (range, 1 to 126 months) for a total of 742.5 person-years at risk (PYRs). Three cases of acute myelogenous leukemia (AML) were reported; only 0.0044 case was expected. The standard incidence ratio (SIR) of AML in this cohort was 680.5 [95% confidence interval (CI), 140.2-1988.5], and the incidence rate per 1000 PYRs was 4.0 (95% CI, 0.8-11.8). For the subgroup treated with single-agent VP-16, the SIR after treatment was 2270.0 (95% CI, 275-8199), and the incidence rate after treatment was 14.7 (95% CI, 1.8-42.8). The study confirms a higher risk of leukemia after LCH and supports the hypothesis of an association between treatment-related acute nonlymphocytic leukemia and single-agent treatment with VP-16.
KW - Etoposide
KW - Langerhans' cell histiocytosis
KW - Late effects
KW - Secondary leukemia
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U2 - 10.3109/08880019409141688
DO - 10.3109/08880019409141688
M3 - Article
C2 - 7826846
AN - SCOPUS:0028018901
VL - 11
SP - 499
EP - 507
JO - Pediatric Hematology and Oncology
JF - Pediatric Hematology and Oncology
SN - 0888-0018
IS - 5
ER -