Table 3.
SMN characteristics of 19 patients with second malignancies after 131I-MIBG therapy.
| ID | SMN diagnosis | SMN biology | SMN treatment | Time from NB diagnosis to SMN (months) | Time from MIBG to SMN (months) | Follow-up time from SMN dx (months) | Cause of death |
|---|---|---|---|---|---|---|---|
| Haematologic malignancies | |||||||
| 1 | ALL, pre-B | 46 XY | TPOG-ALL protocol | 45.1 | 22.6 | 13.9 | MDR sepsis 2/2 treatment for all recurrence |
| 2 | MDS/AML | Monosomy 7 | Umbilical cord blood transplant, 5-azacitidine (for relapse) | 44.6 | 27.0 | 8.0 | NB/AML |
| 3 | MDS/AML | Monosomy 2 | None | 64.0 | 32.0 | 3.0 | AML |
| 4 | AML | Monosomy 7; additional material in long arms of chromosomes 2 and 4 | MTX, Ara-C, HC | 97.8 | 10.7 | 4.0 | AML |
| 5 | AML | Deletion in chromosome 20; t(9; 11) | Hydroxyurea/allopurinol, Ara-C/VP-16, Mylotarg, cyclosporine, Ara-C, fludarabine, clofarabine | 65.8 | 33.1 | 6.6 | AML |
| 6 | T cell ALL | Unknown | None | 52.8 | 40.0 | 0.4 | ALL |
| 7 | AML | Unknown | None | 71.5 | 5.5 | 0.0 | AML/ARDS |
| 8 | AML | Monosomy 5q- | 5-azacytidine | 98.6 | 68.4 | 9.5 | AML |
| 9 | MDS | Trisomy 1q and 7q- t(1; 7) along with subclone containing trisomy 8 | Matched sibHSCT conditioned w/busulfan and fludarabine | 70.6 | 47.4 | 18.4+ | − |
| 10 | MDS | Monosomy 7 | 5-azacytidine | 95.9 | 37.7 | 4.4 | MDS |
| 11 | MDS | Trisomy 11 and der(12p) and monosomy 13. | Unknown | 43.1 | 6.6 | 4.6 | MDS/NB |
| 12 | MDS, AML | Monosomy 5,7q-, Y- | Allogenic HSCT from brother with melphalan, cytoxan, cyclosporin A | 25.3 | 18.8 | 4.6 | ARDS 2/2 HSCT/GVHD |
| 13 | MDS | Monosomy 7 | None | 63.0 | 28.0 | 4.0 | MDS, NB |
| Solid malignancies | |||||||
| 14a | Undifferentiated sarcoma, cranium | Not done | Resection, doxorubicin and isofosfamide, EBRT | 128.9 | 108.4 | 65.8+ | − |
| 14b | Inflammatory myofibroblastic pseudotumour, lung | ALK1 negative by IHC | Resection | 119.1 | 98.6 | 75.6+ | − |
| 15 | Osteosarcoma, R humerus | Stage 2A | Doxorubicin, cisplatin, high dose MTX | 68 | 57.1 | 53.3 | NB |
| 16 | Papillary thyroid carcinoma | Not done | Resection | 131.2 | 69.3 | 33.0+ | − |
| 17 | Peritoneal mesothelioma, pelvis | Translocation 13p11.2 | Unknown | 37.7 | 19.4 | 49.2 | NB |
| 18 | Inflammatory myofibroblastic tumour | ALK1+ by IHC | Unknown | 69.0 | 5.3 | 5.3 | NB |
| 19 | Papillary thyroid carcinoma | Not done | Total thyroidectomy and i131 therapy | 87.4 | 59.4 | 9.6+ | − |
SMN, second malignant neoplasm; MIBG, metaiodobenzylguanidine; NB, neuroblastoma; ALL, acute lymphoblastic leukaemia; TPOG, Turkish paediatric oncology group; MDR, multidrug resistant, MDS, myelodysplastic syndrome; AML, acute myelogenous leukaemia; MTX, methotrexate; Ara-C, cytosine arabinoside; HC, hydrocortisone; VP-16, Etoposide; ARDS, acute respiratory distress syndrome; HSCT, haematopoietic stem cell transplant; GVHD, graft versus host disease; EBRT, external beam radiation therapy; IHC, immunohistochemistry.