Chemotherapy and radiation in childhood can cause rare cancer

Australian children diagnosed with cancer and treated with chemotherapy or radiation therapy are around 50 times more likely to be diagnosed with a secondary therapy-related cancer, compared to the general population.

New research by Children’s Health Queensland and Cancer Council Queensland, found that childhood cancer survivors had a significantly higher risk of being diagnosed with acute myeloid leukaemia later in life.

The study, the largest of its kind, used 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.

The study found that hematopoietic stem cell transplantation following a diagnosis of t-AML offered a better chance of survival.

The findings have prompted Cancer Council Queensland to call for more funding and awareness of this rare disease during Childhood Cancer Awareness Month (September 1-30).

Cancer Council Queensland CEO Ms Chris McMillan said only 31 per cent of people diagnosed with t-AML after another childhood cancer diagnosis survived more than five years.

“Findings showed that 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,” Ms McMillan said.

“Although rare, t-AML is a devastating potential late effect of childhood cancer therapy. Most cases of t-AML occur within two or three years of the original cancer.

“There is still very little known about t-AML but through studies like this we are starting to better understand the cause and impact of this disease and move closer to possible solutions.”

Dr Andy Moore, a Paediatric Oncologist at Children’s Health Queensland and co-lead researcher on the paper, said since 1983, 58 Australians had been diagnosed with t-AML due to chemotherapy and radiation administered during childhood.

“Tremendous improvements in cure rates for many childhood cancers have occurred over the past 40 years,” Dr Moore said.

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

“Therapy-related AML is one of those potential late-effects. As we’ve found through this research, 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 compared to the general population.

“Whilst outcomes are generally poor, our research has also demonstrated that there is hope for those patients with t-AML who can get to a bone marrow transplant.

“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.

“Promisingly, childhood cancer death rates in Australia have decreased by nearly 40 per cent over the past 15 years, however, we still have more work to do,” Ms McMillan said.

“Cancer continues to be the most common cause of disease-related death for children over one.”

If you, or a family you know, has been touched by childhood cancer, please reach out to Cancer Council Queensland today on 13 11 20.

For more information about Cancer Council Queensland or to donate to our work in this area, visit www.cancerqld.org.au.