13 September 2018

Childhood cancer survivors who were treated with chemotherapy or radiation therapy are around 50 times more likely to be diagnosed with a rare secondary therapy-related cancer later in life, new research has found.

The Children’s Health Queensland (CHQ) and Cancer Council Queensland study, the largest of its kind, examined data from the Australian Childhood Cancer Registry to investigate therapy-related acute myeloid leukaemia (t-AML) – a rare form of cancer with a generally poor prognosis.

The records of more than 11,700 Australian children diagnosed with cancer and treated with cytotoxic chemotherapy or radiation therapy, or both, over the past 30 years were examined.

Children’s Health Queensland paediatric oncologist and co-lead researcher Dr Andy Moore said the findings showed children treated with chemotherapy or radiotherapy, or a combination of both, had an almost 50-fold increased risk of being diagnosed with t-AML compared to rates of acute myeloid leukaemia in the general population.

“Although the overall number of patients who develop t-AML is low, the relative risk of developing this form of leukaemia is a lot higher for childhood cancer survivors,” Dr Moore said.

“While outcomes are generally poor, this research has demonstrated that there is hope for patients with t-AML who receive hematopoietic stem cell transplantation (or bone marrow transplant) following their diagnosis.”

Since 1983, 58 Australians had been diagnosed with t-AML due to chemotherapy and radiation administered during childhood, Dr Moore said. Most cases of t-AML occur within two or three years of the original cancer.

“Cure rates for many childhood cancers have improved tremendously in the past 40 years,” Dr Moore said.

“However, we know that achieving those cures sometimes comes at a cost, with late effects of chemotherapy and radiotherapy affecting a number of childhood cancer survivors.”

“It’s clear that ongoing research is needed to find better ways of curing childhood cancer, without the risks of late effects.”

In Australia around 750 children aged 0-14 are currently diagnosed with cancer annually.

The paper ‘Therapy‐related acute myeloid leukemia following treatment for cancer in childhood: A population‐based registry study’ has been published in the September 2018 issue of Paediatric Blood and Cancer.