Cancer monitoring needed for leukemia survivors

By Megan Rauscher

NEW YORK (Reuters Health) - Thirty years after treatment for childhood acute lymphoblastic leukemia, survivors remain at increased risk for developing a second cancer, according to a new report.

Acute lymphoblastic leukemia, or ALL, is the most common type of leukemia seen in children. Like other types of leukemia, it is a cancer of white blood cells that infiltrates the bone marrow, significantly reducing the growth of healthy cells.

"Today, prognosis from childhood ALL is excellent, so now, more and more patients become long-term survivors," Dr. Nobuko Hijiya from St. Jude Children's Research Hospital, Memphis, Tennessee, noted in an interview with Reuters Health.

Until now, little was known about the occurrence of secondary cancers beyond 15 to 20 years in childhood ALL survivors, she added.

Hijiya and colleagues estimated the 30-year rate of second cancers in 2169 children treated for ALL at St. Jude's between 1962 and 1998.

Among the 1290 patients who remained in complete remission, roughly 10 percent developed a second cancer, the team reports in the Journal of the American Medical Association. ALL survivors are 13.5-times more likely to develop cancer than people in the general population, the authors note.

Most of these second cancers are relatively mild, slow-growing tumors, although a substantial number are more aggressive.

"People treated for acute ALL in childhood are surviving into their 40s, 50s and even older, and second malignancies is one of the problems we are seeing," Hijiya said. "By following these patients for their entire lifetime, we may be able to do a better job treating second malignancies."

SOURCE: Journal of the American Medical Association, March 21, 2007.