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High cumulative rate of secondary leukemia after continuous etoposide treatment for solid tumors in children and young adults
Author(s) -
Le Deley MarieCécile,
Vassal Gilles,
Taïbi Ahmed,
Shamsaldin Akthar,
Leblanc Thierry,
Hartmann Olivier
Publication year - 2005
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.20380
Subject(s) - medicine , etoposide , leukemia , pediatrics , oncology , cumulative dose , chemotherapy
Background In a national pediatric case‐control study, we observed a very high relative risk of leukemia in patients who had received continuous etoposide (CE) over 6 months or more, but we could not estimate the absolute risk. The purpose of the present study was to estimate this absolute risk after CE. Procedures We report a study of 18 patients with refractory or recurrent tumors who received CE over 6 months or more between 1995 and 1997. It was administered either 3 days a week for 3/4 weeks (“3 × 3”, 14 patients) or 7 days a week for 3/4 weeks (“7 × 3”, four patients). Results Five patients developed secondary leukemia 10–25 months after the initiation of CE. All the others died of their first tumor. The cumulative incidence of leukemia at 30 months was 28% (95% CI, 10%–53%). A chromosome 11q23 rearrangement was found in 3/5 cases. All four patients who received the “7 × 3” CE schedule developed leukemia compared to 1/14 treated with the “3 × 3” CE schedule ( P = 0.002). Conclusions Given its efficacy, CE may still have a place as a palliative treatment. However, the risk of leukemia must be borne in mind when considering its use in patients with a better prognosis. Pediatr Blood Cancer 2005; 45:25–31. © 2005 Wiley‐Liss, Inc.