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作为儿童急性淋巴细胞白血病之后的第一个事件,二次瘤的累积发病率
Nobuko Hijiya1, Melissa M Hudson, Shelly Lensing
1Department of Oncology, St Jude Children's Research Hospital, Memphis, TN 38105-2794, USA. nobuko.hijiya@stjude.org
JAMA
|March 22, 2007
概括
在儿童急性淋巴细胞白血病幸存者中,二次癌症的风险在30年内显著增加,侵略性瘤的显着增加. 对这些幸存者来说,终身监视至关重要.
科学领域:
- 儿科瘤学 儿科瘤学
- 癌症流行病学 癌症流行病学
- 长期癌症存活率 长期癌症存活率
背景情况:
- 关于儿童急性淋巴细胞白血病 (ALL) 治疗后15-20年后的二次癌症发病率的数据有限.
- 了解长期风险对于改善所有幸存者的结果至关重要.
研究的目的:
- 为了确定30年来儿科ALL患者中二次瘤的累积发病率.
- 在这个群体中描述晚期发生的瘤的类型和模式.
主要方法:
- 在1962-1998年间,对2169名为ALL治疗的儿科患者进行了回顾性分析.
- 平均随访时间为18.7年 (范围为2.4至41.3年).
- 与一般人口相比,累计发病率和标准发病率的计算.
主要成果:
- 在ALL治疗后30年,二次瘤的累积发病率达到10.85%.
- 除了脑膜瘤和基底细胞癌,30年发生率为6.27%,比一般人群增加了13.5倍.
- 观察到骨髓质恶性瘤,脑瘤和癌瘤的显著增加,侵略性新生体发生的频率高于预期.
结论:
- 在儿童ALL治疗后的30年里,二次瘤的发生率稳步上升.
- 晚期出现的瘤,包括侵袭性恶性瘤,构成长期的重大风险.
- 建议对所有幸存者进行终身跟踪,以监测和管理二次癌症的发展.
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