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Risk of subsequent primary leukaemias among 69,460 five-year survivors of childhood cancer diagnosed from 1940 to 2008 in Europe: A cohort study within PanCareSurFup.

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Authors
Allodji, Rodrigue S
Hawkins, Mike M
Bright, Chloe J
Fidler-Benaoudia, Miranda M
Winter, David L
Alessi, Daniela
Fresneau, Brice
Journy, Neige
Morsellino, Vera
Bárdi, Edit
Bautz, Andrea
Byrne, Julianne
Feijen, Elizabeth Lieke Am
Teepen, Jop C
Vu-Bezin, Giao
Rubino, Carole
Garwicz, Stanislaw
Grabow, Desiree
Gudmundsdottir, Thorgerdur
Guha, Joyeeta
Hau, Eva-Maria
Jankovic, Momcilo
Kaatsch, Peter
Kaiser, Melanie
Linge, Helena
Muraca, Monica
Llanas, Damien
Veres, Cristina
Øfstaas, Hilde
Diallo, Ibrahima
Mansouri, Imene
Ronckers, Cecile M
Skinner, Roderick
Terenziani, Monica
Wesenberg, Finn
Wiebe, Thomas
Sacerdote, Carlotta
Jakab, Zsuzsanna
Haupt, Riccardo
Lähteenmäki, Päivi
Zaletel, Lorna Zadravec
Kuehni, Claudia E
Winther, Jeanette F
Michel, Gisela
Kremer, Leontien C M
Hjorth, Lars
Haddy, Nadia
De Vathaire, Florent
Reulen, Raoul C
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Issue Date
2019-08

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Risk of subsequent primary leukaemias among 69,460 five-year survivors of childhood cancer diagnosed from 1940 to 2008 in Europe: A cohort study within PanCareSurFup. 2019, 117: 71-83 Eur J Cancer
Abstract
BACKGROUND: Survivors of childhood cancers are at risk of developing subsequent primary leukaemias (SPLs), but the long-term risks beyond 20 years of treatment are still unclear. We investigated the risk of SPLs in five-year childhood cancer survivors using a large-scale pan-European (PanCareSurFup) cohort and evaluated variations in the risk by cancer and demographic factors. METHODS: This largest-ever assembled cohort comprises 69,460 five-year childhood cancer survivors from 12 European countries. Standardised incidence ratios (SIRs) and absolute excess risks (AERs) were calculated. RESULTS: One hundred fifteen survivors developed an SPL including 86 myeloid leukaemias (subsequent primary myeloid leukaemias [SPMLs]), 17 lymphoid leukaemias and 12 other types of leukaemias; of these SPLs, 31 (27%) occurred beyond 20 years from the first childhood cancer diagnosis. Compared with the general population, childhood cancer survivors had a fourfold increased risk (SIR = 3.7, 95% confidence interval [CI]: 3.1 to 4.5) of developing leukaemia, and eight leukaemias per 100,000 person-years (AER = 7.5, 95% CI: 6.0 to 9.2) occurred in excess of that expected. The risks remained significantly elevated beyond 20 years from the first primary malignancy (SIR = 2.4, 95% CI: 1.6 to 3.4). Overall, the risk ratio for SPML (SIR = 5.8, 95% CI: 4.6 to 7.1) was higher than that for other SPLs. CONCLUSIONS: We demonstrate that beyond 20 years after childhood cancer diagnosis, survivors experience an increased risk for SPLs compared with that expected from the general population. Our findings highlight the need for awareness by survivors and their healthcare providers for potential risk related to SPL.
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Additional Links
https://www.sciencedirect.com/science/article/pii/S0959804919303168
ae974a485f413a2113503eed53cd6c53
10.1016/j.ejca.2019.05.013
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English Journal Articles (Peer Reviewed)

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