Please use this identifier to cite or link to this item: https://scholarbank.nus.edu.sg/handle/10635/209037
Title: Second Malignant Neoplasms in Childhood Cancer Survivors Treated in a Tertiary Paediatric Oncology Centre
Authors: Lim, Jia Wei 
Yeap, Frances SH 
Chan, Yiong Huak 
Yeoh, Allen EJ 
Thuan, Chong Quah 
Poh, Lin Tan
Keywords: Science & Technology
Life Sciences & Biomedicine
Medicine, General & Internal
General & Internal Medicine
Late effects
Long-term cancer survivors
Topoisomerase II inhibitor
ACUTE LYMPHOBLASTIC-LEUKEMIA
LONG-TERM SURVIVORS
5-YEAR SURVIVORS
SECONDARY NEOPLASMS
NORDIC COUNTRIES
BRITISH-COLUMBIA
LATE MORTALITY
RISK
SUBSEQUENT
OSTEOSARCOMA
Issue Date: 1-Jan-2017
Publisher: ACAD MEDICINE SINGAPORE
Citation: Lim, Jia Wei, Yeap, Frances SH, Chan, Yiong Huak, Yeoh, Allen EJ, Thuan, Chong Quah, Poh, Lin Tan (2017-01-01). Second Malignant Neoplasms in Childhood Cancer Survivors Treated in a Tertiary Paediatric Oncology Centre. ANNALS ACADEMY OF MEDICINE SINGAPORE 46 (1) : 11-19. ScholarBank@NUS Repository.
Abstract: Introduction: One of the most feared complications of childhood cancer treatment is second malignant neoplasms (SMNs). This study evaluates the incidence, risk factors and outcomes of SMNs in a tertiary paediatric oncology centre in Singapore. Materials and Methods: A retrospective review was conducted on patients diagnosed with childhood cancer under age 21 and treated at the National University Hospital, Singapore, from January 1990 to 15 April 2012. Case records of patients with SMNs were reviewed. Results: We identified 1124 cases of childhood cancers with a median follow-up of 3.49 (0 to 24.06) years. The most common primary malignancies were leukaemia (47.1%), central nervous system tumours (11.7%) and lymphoma (9.8%). Fifteen cases developed SMNs, most commonly acute myeloid leukaemia/myelodysplastic syndrome (n = 7). Median interval between the first and second malignancy was 3.41 (0.24 to 18.30) years. Overall 20-year cumulative incidence of SMNs was 5.3% (95% CI, 0.2% to 10.4%). The 15-year cumulative incidence of SMNs following acute lymphoblastic leukaemia was 4.4% (95% CI, 0% to 8.9%), significantly lower than the risk after osteosarcoma of 14.2% (95% CI, 0.7% to 27.7%) within 5 years (P <0.0005). Overall 5-year survival for SMNs was lower than that of primarymalignancies. Conclusion: This study identified factors explaining the epidemiology of SMNs described, and found topoisomerase II inhibitor use to be a likely risk factor in our cohort. Modifications have already been made to our existing therapeutic protocols in osteosarcoma treatment. We also recognised the importance of other risk management strategies, including regular long-term surveillance and early intervention for detected SMNs, to improve outcomes of high risk patients.
Source Title: ANNALS ACADEMY OF MEDICINE SINGAPORE
URI: https://scholarbank.nus.edu.sg/handle/10635/209037
ISSN: 03044602
Appears in Collections:Staff Publications
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