Is age an independent risk factor for chemically induced acute myelogenous leukemia in children?

Pyatt, David W., Aylward, Lesa L. and Hays, Sean M. (2007) Is age an independent risk factor for chemically induced acute myelogenous leukemia in children?. Journal of Toxicology and Environmental Health. Part B: Critical Reviews, 10 5: 379-400. doi:10.1080/15287390600975061


Author Pyatt, David W.
Aylward, Lesa L.
Hays, Sean M.
Title Is age an independent risk factor for chemically induced acute myelogenous leukemia in children?
Journal name Journal of Toxicology and Environmental Health. Part B: Critical Reviews   Check publisher's open access policy
ISSN 1093-7404
1521-6950
Publication date 2007-08
Sub-type Article (original research)
DOI 10.1080/15287390600975061
Open Access Status Not yet assessed
Volume 10
Issue 5
Start page 379
End page 400
Total pages 22
Place of publication New York, NY, United States
Publisher Taylor & Francis
Language eng
Abstract Secondary or therapy-related acute myelogenous leukemia (t-AML) is a rare but unfortunate consequence of treatment with certain classes of cytotoxic chemotherapeutic agents or chronic exposure to high concentrations of benzene. Drugs known to produce AML following chemotherapy of primary malignancy are usually alkylating agents or topoisomerase II inhibitors. Both children and adults develop AML following treatment with these classes of antineoplastic drugs. In this review, the effect of age at treatment on a child's susceptibility to developing therapy related AML was investigated. The clinical literature describing pediatric cancer patients treated with cytotoxic chemotherapeutic agents was used to characterize risk factors associated with chemical leukemogenesis in children. As demonstrated in the published literature, the risk of developing AML following chemotherapy is not reliably correlated with the age of the pediatric patient. There is no consistent evidence that indicates that younger children will be at increased risk; in fact, some studies suggest that younger children might actually display a decreased susceptibility. The age dependency of treatment-related malignancies (all types) in children appears to vary considerably with the type of secondary neoplasm in question. For example, secondary solid tumors such as breast, central nervous system (CNS), bone, and thyroid cancer are highly dependent on the age of the patient at time of diagnosis and treatment; in contrast, an age dependency for t-AML risk was not observed in these same patient populations. Predictably, the induction of t-AML in children follows a rational dose-response relationship, with increasing doses of chemotherapy resulting in greater risk. Recent U.S. Environmental Protection Agency (EPA) cancer risk assessment guidance recommends a default assumption that children are inherently up to 10-fold more sensitive than adults to carcinogen exposures. Available scientific and medical literature does not support the hypothesis that children necessarily possess an increased risk of developing AML following leukemogenic chemical exposure. Copyright
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Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: National Research Centre for Environmental Toxicology Publications
 
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