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2000年新增病例2000例 美国每年都有。目前的治疗方法超过了其中的一半 儿童的疾病将被治愈，并将面临患上 他们治疗的后遗症。我们建议进行一项多方面的研究 儿童后发生的第二种恶性肿瘤(SMN) 全。研究的第一阶段将确定所有SMN病例 发生在儿童中，在儿童中登记的ALL 癌症研究小组(CCSG)自1972年以来。估计的风险 在童年后发展成SMN将被计算和 对这类患者的特点进行了描述。 将进行队列分析，以努力识别患者 诊断时出现的所有可能的特征 预测SMN的发生风险增加。 研究的第二阶段将进行两项病例对照研究 指挥。这些病例对照研究中的第一项将检查 与诊断时患者特征相关的风险以及 化疗和放射治疗对人肺癌的特异性影响 第二种恶性肿瘤的发生。有关以下信息： 年龄、性别、白细胞计数、形态和免疫学特征 的白血病细胞由CCSG为所有患者维护 并将提供给这项研究进行分析。治疗法 将审查病例和控制的记录，以进行分析 特异性化疗药物和放射治疗的效果 心理治疗。第二项病例对照研究将检验这一假设。 处于SMN发展风险中的人群可能是 由患者过去的病史、家族史或 曝光。我们会就个案进行电话访问， 关于多个参数获取的控件和数据 包括家族癌症病史、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，以及先前存在的病人疾病。 然后将对这些数据进行分析，以努力确定 可定义高危人群的参数。这个 从这项研究中获得的信息将对 作为修饰的信息被用来降低毒性 同时保留现有治疗方案的疗效 童年的一切。 还将进行病例对照研究，以努力 确定神经母细胞瘤的产前和围产期危险因素， 出生第一年最常见的恶性肿瘤。本研究 将使用出生证明上的编码信息，并 神经母细胞瘤病例补充信息表 在明尼苏达州被确认并出生，并与对照组相匹配。这个 这项研究的结果可以为产前研究提供有价值的见解 以及几种儿科肿瘤对围产期的影响。

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.