SECOND MALIGNANT NEOPLASMS FOLLOWING CHILDHOOD LEUKEMIA

急性淋巴细胞白血病（ALL）是最常见的 儿童恶性肿瘤，估计有2000例新发病例， 美国每年。 根据目前的治疗方法， 儿童将被治愈他们的疾病，并将在风险， 治疗的后期效应 我们建议进行多方面的研究 儿童期后发生的第二次恶性肿瘤（SMN） 所有. 研究的第一阶段将确定所有SMN病例 发生在儿童登记的ALL儿童中 癌症研究小组（CCSG）自1972年以来。 的估计风险 将计算在儿童ALL后发展SMN， 对本组患者的特征进行描述。 将进行队列分析，以确定患者 在诊断ALL时存在的特征， 预测SMN发生的风险增加。 在 研究的第二阶段将进行两项病例对照研究， 进行。 这些病例对照研究中的第一个将检查 与诊断时患者特征相关的风险， 化疗和放射治疗的具体影响， 发生第二次恶性肿瘤。 信息 年龄、性别、白细胞计数、形态学和免疫学特征 的白血病细胞由CCSG为所有患者维持 并将提供给本研究进行分析。 治疗 将审查病例和对照的记录， 特定化疗剂和放射的作用 疗法 第二个病例对照研究将检验这一假设 有SMN发展风险的人群可能 患者描述的既往病史、家族史或 暴露。 将对案件进行电话访谈， 关于多个参数的控制和数据 包括家族癌症史、其他重大家族疾病 病史、专利暴露和职业、患者暴露， 产前和围产期事件，以及原有的患者疾病。 然后将对这些数据进行分析，以确定 可以定义风险人群的参数。 的 从这项研究中获得的信息将有助于重要 信息作为修改，以降低毒性 同时保持现有治疗方案的功效， 童年全部 还将进行病例对照研究， 确定神经母细胞瘤的产前和围产期风险因素， 是一岁以内最常见的恶性肿瘤 本研究 将利用出生证明上的编码信息， 神经母细胞瘤病例补充信息表 在明尼苏达州出生并匹配对照组。 的 这项研究的结果可以提供有价值的见解，产前 和围产期影响的几个儿科肿瘤。

Acute lymphoblastic leukemia (ALL) is the most common malignancy of childhood with and estimated 2000 new cases in the United States each year. With current therapy over half of these children will be cured of their disease and will be at risk for the late effects of their therapy. We propose a multi-faceted study of Second Malignant Neoplasms (SMN's) occurring after childhood ALL. The first phase of the study will identify all cases of SMN's occurring in children with ALL registered with the Childrens Cancer Study Group (CCSG) since 1972. The estimated risk of developing a SMN following childhood ALL will be calculated and patient characteristics of this group of patients described. Cohort analysis will be performed in an effort to identify patient characteristics present at the time of diagnosis of ALL that may be predictive of increased risk for the occurrence of SMN's. In the second phase of the study two case-control studies will be conducted. The first of these case-control studies will examine risk associated with patient characteristics at diagnosis and the specific effects of chemotherapies and radiation therapy on the occurrence of second malignant neoplasms. Information regarding age, sex, WBC count, morphology, and immunologic characteristic of the leukemic cells are maintained for all patients by the CCSG and will be made available to this study for analysis. Therapy records for cases and controls will be reviewed for analysis of the effects of specific chemotherapeutic agents and radiation therapy. The second case-control study will test the hypothesis that a population at risk for the development of SMN's can be described by the patients past medical history, family history, or exposures. Telephone interviews will be conducted for cases and controls and data obtained regarding multiple parameters including family cancer history, other significant family disease history, patental exposures and occupations, patients exposures, pre-natal and peri-natal events, and pre-existing patient illnesses. These data will then be analyzed in an effort to identify any parameters that may define an at risk population. The information gained from this study will contribute important information as modification are made to decrease the toxicity while preserving the efficacy of existing treatment protocols for childhood ALL. A case-controls study will also be undertaken in an effort to identify pre-natal and peri-natal risk factors for neuroblastoma, the most common malignancy in the first year of life. This study will utilize information coded on birth certificates and supplemental information forms for cases of neuroblastoma identified and born in Minnesota and matched controls. The results of this study can provide valuable insight into pre-natal and peri-natal influences of several pediatric neoplasms.