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Children 2015, 2(2), 146-173; doi:10.3390/children2020146

Secondary Malignant Neoplasms Following Haematopoietic Stem Cell Transplantation in Childhood

1,†
and
1,2,†,*
1
Department of Paediatric and Adolescent Haematology/Oncology, Great North Children's Hospital, Newcastle upon Tyne, NE1 4LP, UK
2
Children's Haemopoietic Stem Cell Transplant Unit, Great North Children's Hospital, Newcastle upon Tyne, NE1 4LP, UK
These authors contributed equally to this work.
*
Author to whom correspondence should be addressed.
Academic Editors: Paul Nathan and Lillian Sung
Received: 10 December 2014 / Revised: 3 April 2015 / Accepted: 8 April 2015 / Published: 21 April 2015
(This article belongs to the Special Issue Acute and Long-Term Sequelae of Childhood Cancer Therapy)
View Full-Text   |   Download PDF [417 KB, uploaded 21 April 2015]

Abstract

Improving survival rates in children with malignancy have been achieved at the cost of a high frequency of late adverse effects of treatment, especially in intensively treated patients such as those undergoing haematopoietic stem cell transplantation (HSCT), many of whom suffer the high burden of chronic toxicity. Secondary malignant neoplasms (SMNs) are one of the most devastating late effects, cause much morbidity and are the most frequent cause of late (yet still premature) treatment-related mortality. They occur in up to 7% of HSCT recipients by 20 years post-HSCT, and with no evidence yet of a plateau in incidence with longer follow-up. This review describes the epidemiology, pathogenesis, clinical features and risk factors of the three main categories of post-HSCT SMNs. A wide range of solid SMNs has been described, usually occurring 10 years or more post-HSCT, related most often to previous or conditioning radiotherapy. Therapy-related acute myeloid leukaemia/myelodysplasia occurs earlier, typically three to seven years post-HSCT, mainly in recipients of autologous transplant and is related to previous alkylating agent or topoisomerase II inhibitor chemotherapy. Post-transplant lymphoproliferative disorders occur early (usually within two years) post-HSCT, usually presenting as Epstein-Barr virus-related B cell non-Hodgkin lymphoma. View Full-Text
Keywords: children; secondary malignant neoplasm; haematopoietic stem cell transplant; therapy-related acute myeloid leukaemia; post-transplant lymphoproliferative disorders children; secondary malignant neoplasm; haematopoietic stem cell transplant; therapy-related acute myeloid leukaemia; post-transplant lymphoproliferative disorders
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Bomken, S.; Skinner, R. Secondary Malignant Neoplasms Following Haematopoietic Stem Cell Transplantation in Childhood. Children 2015, 2, 146-173.

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