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Fanconi anemia and solid malignancies in childhood: A national retrospective study
Author(s) -
Malric Aurore,
Defachelles AnneSophie,
Leblanc Thierry,
Lescoeur Brigitte,
Lacour Brigitte,
Peuchmaur Michel,
Maurage ClaudeAlain,
Pierron Gaëlle,
Guillemot Delphine,
d'Enghien Catherine Dubois,
Soulier Jean,
StoppaLyonnet Dominique,
Bourdeaut Franck
Publication year - 2015
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.25303
Subject(s) - medicine , fanconi anemia , malignancy , hepatoblastoma , cancer , pediatrics , chemotherapy , anemia , retrospective cohort study , oncology , biochemistry , chemistry , dna repair , gene
Background Fanconi anemia (FA) predisposes to hematologic disorders and myeloid neoplasia in childhood and to solid cancers, mainly oral carcinomas, in early adulthood. Few cases of solid cancers have been reported in childhood. Procedures We conducted a national retrospective study of solid tumors occurring in patients registered with or determined to have FA during childhood in France. Phenotypic features, tumor type, cancer treatment, and outcome were analyzed. Whenever available, fresh‐frozen tumors were analyzed by microarray‐based comparative genomics hybridization. Results We identified eight patients with FA with solid tumor from 1986 to 2012. For two patients, the diagnosis of FA was unknown at the time of cancer diagnosis. Moreover, we identified one fetus with a brain tumor. All patients showed failure to thrive and had dysmorphic features and abnormal skin pigmentation. Seven patients had BRCA2/FANCD1 mutations; five of these featured more than one malignancy and the median age at the time of cancer diagnosis was 11 months (range 0.4–3 years). Solid tumor types included five nephroblastomas, two rhabdomyosarcomas, two neuroblastomas, and three brain tumors. Two children died from the toxic effects of chemotherapy, two patients from the cancer, and one patient from secondary leukemia. Only one BRCA2 patient was alive more than 3 years after diagnosis, after tailored chemotherapy. Conclusion Solid tumors are rare in FA during childhood, except in patients with BRCA2/FANCD1 mutations. The proper genetic diagnosis is mandatory to tailor the treatment. Pediatr Blood Cancer 2015;62:463–470. © 2014 Wiley Periodicals, Inc.