Investigation of secondary cancer and diseases in patients receiving treatment for childhood leukemia disease

Acute leukemia is a clonal disease characterized by the arrest of normal lymphoid and myeloid stem cells at a specific stage of hematopoiesis and their unlimited proliferation ability (1). In this study, the information of a total of 378 acute leukemia cases diagnosed and treated between 2005 and 2017 in the Pediatric Hematology Clinic of Uludağ University Medical Faculty Hospital was evaluated retrospectively, considering the literature. Secondary malignancies that occured at least 5 years after the completion of treatment in childhood leukemia cases were investigated, and whether there was a connection between secondary malignancies and chemotherapy protocols was investigated,or not. Of the 378 patients included in the study, 15.3% (n=58) were diagnosed with AML and 84.3% (n=319) were diagnosed with ALL. Secondary cancer developed in 9 of our 378 patients. Secondary malignancy development rate is 2.839% in patients with ALL, and this rate is 1.724% in patients with AML. The mortality rate of ALL patients was 24.3%, and AML patients was 44.8% (p=0.001<0.05). The causes of mortality in patients diagnosed with ALL/AML were evaluated, and resistant ALL (42.157%) and resistant AML (18.627%) were found to be the highest causes of mortality. As a result, among the treatment protocols investigated in our study, it was found that the relapse seen in patients treated with BFM-2009 for ALL was statistically significantly less (p=0.046<0.05), and the mortality of AML patients was higher than in ALL patients. Key words: Childhood acute leukemias, chemotherapy protocols, , relapse of childhood leukemias, bone marrow transplantation, secondary malignancy.