Second malignancy in acute lymphocytic leukemia. Review of 33 cases
A. D. Mosijczuk and F. B. Ruymann
Improved survival in childhood cancer resulting from advances in therapy is
frequently associated with long-term morbidity, including the potential for
second malignancy. In a review of the literature in the English language,
we found 33 cases of acute lymphocytic leukemia (ALL) followed by a second
neoplasm. Second tumors in this group of patients with ALL include seven
cases of histiocytic medullary reticulosis, four cases of Hodgkin's
disease, nine cases of acute myelocytic leukemia, four cases of chronic
myelocytic leukemia, and nine cases of solid tumors. The appearance of
subsequent malignancies may be related to a combination of therapy-induced
immunosuppression, a direct carcinogenic effect resulting from therapy,
and/or constitutional factors. Physicians should be alert to the
possibility of subsequent malignant neoplasms in survivors of cancer.
