Risk of therapy related acute myeloid leukemia following treatment with epipodophyllotoxins in Langerhans cell histiocytosis

Abstract

Sixty-five children with biopsy-proven Langerhans cell histiocytosis (LCH) were managed at the Department of Pediatric Oncology, Hacettepe University from 1986 to 1992. Sixteen were treated with etoposid (VP-16). Eight received VP-16 as first line therapy and eight as second, third or fourth choice. Patients ranged in age from seven months to eleven years (median 31 months). Male:female ratio was one. The median total dose of VP-16 was 2850 mg/m2 (range 1500-4950 mg/m2) and the median time from tire beginning of therapy was 34 months (range 20-46 months). Schedule of drug administration was once every three weeks. Noue of the patients, whether receiving VP-16 alone or being treated with other chemotherapeutics, developed secondary malignancy although enough time has passed as reported in the literature. No clear conclusion can be drawn in favor of any increased risk for LCH children treated with VP-16. [Turk J Cancer i995;25(4):i61-67]