Incidence of secondary malignancies in Polish children treated for acute lymphoblastic leukemia according to the ALL-IC BFM 2002 protocol

Kamila Wypyszczak; Agata Pastorczak; Jerzy Kowalczyk; Tomasz Szczepański; Monika Lejman; Walentyna Balwierz; Bernarda Kazanowska; Katarzyna Derwich; Elżbieta Adamkiewicz-Drożyńska; Joanna Trelińska; Andrzej Kołtan; Maryna Krawczuk-Rybak; Tomasz Ociepa; Tomasz Urasiński; Grażyna Sobol-Milejska; Grażyna Karolczyk; Paweł Łaguna; Jan Styczyński; Jacek Wachowiak; Wojciech Młynarski

doi:10.5114/polp.2024.146417

eISSN: 2300-8660
ISSN: 0031-3939

Pediatria Polska - Polish Journal of Paediatrics

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Artykuł oryginalny

Incidence of secondary malignancies in Polish children treated for acute lymphoblastic leukemia according to the ALL-IC BFM 2002 protocol

Kamila Wypyszczak

¹

,

Agata Pastorczak

²

,

Jerzy Kowalczyk

³

,

Tomasz Szczepański

⁴

,

Monika Lejman

⁵

,

Walentyna Balwierz

⁶

,

Bernarda Kazanowska

⁷

,

Katarzyna Derwich

⁸

,

Elżbieta Adamkiewicz-Drożyńska

⁹

,

Joanna Trelińska

¹⁰

,

Andrzej Kołtan

¹¹

,

Maryna Krawczuk-Rybak

¹²

,

Tomasz Ociepa

¹³

,

Tomasz Urasiński

¹³

,

Grażyna Sobol-Milejska

¹⁴

,

Grażyna Karolczyk

¹⁵

,

Paweł Łaguna

¹⁶

,

Jan Styczyński

¹¹

,

Jacek Wachowiak

⁸

,

Wojciech Młynarski

¹⁷

Department of Genetic Predisposition to Cancer, Medical University of Lodz, Poland
Department of Genetic Predisposition to Cancer, Department of Pediatrics, Oncology and Hematology, Central Clinical Hospital, Lodz, Poland
Department of Pediatric Hematology, Oncology and Transplantology, Medical University of Lublin, Poland
Department of Pediatrics, Hematology and Oncology, Medical University of Zabrze, Zabrze, Poland
Laboratory of Genetic Diagnostics, Medical University of Lublin, Lublin, Poland
Department of Pediatric Oncology and Hematology, Children’s University Hospital, Jagiellonian University, Krakow, Poland
Department of Pediatric Transplantology, Oncology, Hematology, Medical University of Wroclaw, Wroclaw, Poland
Department of Pediatric Oncology, Hematology and Transplantology, Medical University of Poznan, Poznan, Poland
Department of Pediatrics, Hematology, Oncology and Endocrinology, Medical University of Gdansk, Gdansk, Poland
Department of Pediatrics, Oncology and Hematology, Medical University of Lodz, Lodz, Poland
Department of Pediatrics, Hematology and Oncology, Collegium Medicum of Bydgoszcz, Bydgoszcz, Poland
Department of Pediatric Oncology, Hematology, Medical University of Bialystok, Bialystok, Poland
Department of Pediatrics, Hemato-Oncology and Pediatric Gastroenterology, Medical University of Szczecin, Szczecin, Poland
Department of Pediatrics, Medical University of Katowice, Katowice, Poland
Department of Pediatric Oncology and Hematology, Children’s Hospital, Kielce, Poland
Department of Pediatric Oncology, Hematology, Clinical Transplantation and Pediatrics, Medical University of Warsaw, Warsaw, Poland
Department of Pediatrics, Oncology and Hematology, Central Clinical Hospital, Lodz, Poland

Pediatr Pol 2024; 99 (4): 291-296

DOI: https://doi.org/10.5114/polp.2024.146417

Data publikacji online: 2024/12/30

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AMA

Wypyszczak K, Pastorczak A, Kowalczyk J, et al. Incidence of secondary malignancies in Polish children treated for acute lymphoblastic leukemia according to the ALL-IC BFM 2002 protocol. Pediatria Polska - Polish Journal of Paediatrics. 2024;99(4):291-296. doi:10.5114/polp.2024.146417.

APA

Wypyszczak, K., Pastorczak, A., Kowalczyk, J., Szczepański, T., Lejman, M.,  & Balwierz, W. et al. (2024). Incidence of secondary malignancies in Polish children treated for acute lymphoblastic leukemia according to the ALL-IC BFM 2002 protocol. Pediatria Polska - Polish Journal of Paediatrics, 99(4), 291-296. https://doi.org/10.5114/polp.2024.146417

Chicago

Wypyszczak, Kamila, Agata Pastorczak, Jerzy Kowalczyk, Tomasz Szczepański, Monika Lejman, Walentyna Balwierz,  and Bernarda Kazanowska et al. 2024. "Incidence of secondary malignancies in Polish children treated for acute lymphoblastic leukemia according to the ALL-IC BFM 2002 protocol". Pediatria Polska - Polish Journal of Paediatrics 99 (4): 291-296. doi:10.5114/polp.2024.146417.

Harvard

Wypyszczak, K., Pastorczak, A., Kowalczyk, J., Szczepański, T., Lejman, M., Balwierz, W., Kazanowska, B., Derwich, K., Adamkiewicz-Drożyńska, E., Trelińska, J., Kołtan, A., Krawczuk-Rybak, M., Ociepa, T., Urasiński, T., Sobol-Milejska, G., Karolczyk, G., Łaguna, P., Styczyński, J., Wachowiak, J.,  and Młynarski, W. (2024). Incidence of secondary malignancies in Polish children treated for acute lymphoblastic leukemia according to the ALL-IC BFM 2002 protocol. Pediatria Polska - Polish Journal of Paediatrics, 99(4), pp.291-296. https://doi.org/10.5114/polp.2024.146417

MLA

Wypyszczak, Kamila et al. "Incidence of secondary malignancies in Polish children treated for acute lymphoblastic leukemia according to the ALL-IC BFM 2002 protocol." Pediatria Polska - Polish Journal of Paediatrics, vol. 99, no. 4, 2024, pp. 291-296. doi:10.5114/polp.2024.146417.

Vancouver

Wypyszczak K, Pastorczak A, Kowalczyk J, Szczepański T, Lejman M, Balwierz W et al. Incidence of secondary malignancies in Polish children treated for acute lymphoblastic leukemia according to the ALL-IC BFM 2002 protocol. Pediatria Polska - Polish Journal of Paediatrics. 2024;99(4):291-296. doi:10.5114/polp.2024.146417.

Metryki PlumX:

Introduction:
Acute lymphoblastic leukemia (ALL) is the most commonly diagnosed childhood cancer, with a peak incidence around 5 years of age. Aim of the study was to assess the incidence, type, and outcome of secondary malignancies in children who were primarily treated for ALL.

Material and methods:
We enrolled in the analysis 1868 children uniformly treated for ALL between 2 October 2002 and 22 December 2012 according to the protocol ALL-IC BFM 2002. In this study group, we assessed the incidence and type of secondary cancer and outcome.

Results:
We identified 12 patients (0.64%) who developed secondary malignancies after the median time of 1.72 years from the primary diagnosis of ALL (range: 11.5 months to 18 years). The most frequently diagnosed second neoplasms were hematological malignancies (8 out of 12; 66.7%) including acute myeloid leukemia (AML) (n = 4), non-Hodgkin lymphoma (NHL) (n = 2), chronic myeloid leukemia (CML) (n = 1), and leukemia of unknown immunophenotype (n = 1). In total, four children developed subsequent solid tumors: Ewing sarcoma (n = 1), primitive neuroectodermal tumor (n = 1), myeloid sarcoma (n = 1), and solid tumors of unknown origin (n = 1). Children diagnosed with second cancer were non-significantly older at primary ALL diagnosis in comparison with patients without second cancer (12.083 [3.4–14.0] vs. 5.25 [3.2–10.2]; p = 0.063). The risk group distribution differed between patients with and without a second cancer: 2 (16.67%) vs. 606 (32.65%) children were assigned to the standard risk (SR) group, 5 (41.67%) vs. 894 (48.17%) in the intermediate risk (IR) group, and 5 (41.67%) vs. 356 (19.18%) in the high risk (HR) group. Patients with secondary malignancies showed a significantly lower probability of 5-year overall survival as compared to children without subsequent tumors: 26.5% vs. 85.7%; p < 10^–5; HR = 5.9; 95% CI: 2.91–11.96.

Conclusions:
Blood cancers are the most frequently observed malignancies in children treated for ALL during the first 3 years after treatment completion. Diagnosis of secondary tumor after being treated for ALL is related to poor outcome.