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Second malignancy in acute lymphocytic leukemia
774
ABSTRACTS
limped, but without pain. One of the patients developed osteonecrosis. Those patients treated with various manipulative efforts a n d / o r surgical efforts to reduce the displacement had a much higher incidence of chondrolysis and osteonecrosis. The safest of all surgical procedures was found to be a subtrochanteric osteotomy. This is an excellent long term study of epiphyseolysis reporting the usefulness of a conservative treatment approach.--Anthony H, Alter Growth Changes in Fractured Long Bones. D. A. Reynolds. J Bone Joint Surg 63B:83-88, (February), 1981.
Following fracture of either femur or tibia in 126 children the growth rate was studied by an accurate radiographic technique. The growth rate remained significantly raised for 2 yr having reached its m a x i m u m about 3 mo after injury when the growth rate was 38% in excess of normal. In fracture of the femur, the uninjured tibia shared the increase in growth rate, but with fracture of the tibia, the uninjured femur was not affected. The occurrence of the increase in growth rate and its effect in lessening leg length discrepancy must be considered when contemplating surgical correction of leg l e n g t h . - - M . G. H. Smith Fracture of the Intercondylar Eminence of the Tibia. M.-L.
Molander, G. Wallin, and 1. Wikstad. J Bone Joint Surg 63B:89-91, (February), 1981. In a series of 35 patients of whom 28 were children, a follow-up of the results of treatment of fracture of the intercondylar eminence of the tibia revealed that despite the persistence of a projection of the bone fragment in all patients this did not correlate with the degree of fracture or late symptoms. The results indicate that in most fractures conservative treatment is satisfactory.--M. G. H. Smith Postero-Medial Bowing of the Tibia: Progression of Discrepancy in Leg Lengths. A. Hofmann and D. R. Wenger.
J Bone Joint Surg 63A:384 388, (March), 1981. Thirteen children who had posteromedial bowing of the tibia were studied. The literature, to date, documents a good response to conservative therapy for this neonatal lesion, but does not discuss associated limb length discrepancy. The authors showed, by scanogram measurement, a leg length discrepancy ranging from 1.9 to 5.6 cm, with a mean of 3.1 cm. The discrepancy tended to increase with time.--Anthony H. Alter
NERVOUS SYSTEM Prenatal Detection of Neural Tube Defects. Vl. Experience With 20,000 Pregnancies. A. M. Milunsky. J A M A
244:2431-2735, (December 19), 1980. Neural tube defects (NTDs) are common, occurring in 1 in 500 pregnancies in the United States. If a previous infant has been affected the risk of recurrence is 1.5%-2%. Most of the author's experience was with otherwise normal pregnancies who were studied because of advanced maternal age and in these the neural tube defect rate was 1 of 437. He states that there have been no false negatives and that the practical false positive rate is 0.06%. He recommends that all patients at risk for N T D (previous sibling affected) have an alpha-
fetoprotein analysis of the amniotic fluid, at an early stage of pregnancy, when termination would be possible.--David L. Collins Folic Acid and Mental Symptoms in Children with Epilepsy.
M. R. Trimble, J. A. Corbett, and D. Donaldson. J Neurol Neurosurg Psychiatr 43:1030-1034, (November), 1980. Three-hundred and twelve of 314 epileptic children resident at a hospital school were examined. Anticonvulsants, especially phenytoin, lower serum folic acid levels. Children with a fall in IQ, neurotic disturbance and depression all had significantly lower serum folic acid levels than the rest of the population.--R. J. Brereton
NEOPLASMS The Epidemiology of Cancer: An Overview. D. Schottenfeld.
Cancer 47:1095-1108, (March), 1981. This is a review by one of the nations leading cancer epidemiologists. Of interest is a section on children and young adults which reflects for the first time the impact on survival rates of the impressive progress that has been made in the treatment of children with specific types of cancer (kidney, bone, acute leukemia). Mortality from childhood cancer has declined from nearly 90 per million per year in 1950, to a current level of approximately 50 per million per year. Cancer is seen in approximately 6000 children annually (U.S.). The incidence is 35% higher in males than females and significantly higher in white children. Acute leukemia and tumors of the C N S account for approximately 75% of current deaths. Testicular cancer and Ewing's sarcoma are rare among blacks in the U.S. Statistical data on additional childhood neoplasms are presented.--Daniel Hays Second Malignancy in Acute Lymphocytic Leukemia. A. D.
Mosijczuk and F. B. Ruymann. A m J Dis Child 135:313316, (April), 1981. Improved survival in childhood cancer resulting from advances in therapy is frequently associated with long term morbidity, including the potential for second malignancy. A review of the English language literature disclosed 33 cases of acute lymphocytic leukemi~ (ALL) followed by a second neoplasm. Second tumors in this group included seven cases of histiocytic medullary reticulosis, four cases of Hodgkin's disease, nine cases of acute myelocytic leukemia, four cases of chronic myelocytic leukemia, and nine cases of solid tumors. The appearance of subsequent malignancies m a y be related to a combination of therapy induced immunosuppression, a direct carcinogenic effect resulting from therapy, a n d / o r constitutional factors. Physicians should be alert to the possibility of subsequent malignant neoplasms in survivors of cancer.--J. J. Tepas Ganglioneuroblastoma of the Posterior Mediastinum: A Clinicopathologic Review of 80 Cases. A, Adam and L.
Hochholzer. Cancer 47:373-381, (January), 1981. This is a review of 80 cases of "ganglioneuroblastoma" of the posterior mediastinum from the Armed Forces Institute of Pathology. They were extracted from the 252 tumors of the sympathetic ganglia, originating in the mediastinum, and
ABSTRACTS
limped, but without pain. One of the patients developed osteonecrosis. Those patients treated with various manipulative efforts a n d / o r surgical efforts to reduce the displacement had a much higher incidence of chondrolysis and osteonecrosis. The safest of all surgical procedures was found to be a subtrochanteric osteotomy. This is an excellent long term study of epiphyseolysis reporting the usefulness of a conservative treatment approach.--Anthony H, Alter Growth Changes in Fractured Long Bones. D. A. Reynolds. J Bone Joint Surg 63B:83-88, (February), 1981.
Following fracture of either femur or tibia in 126 children the growth rate was studied by an accurate radiographic technique. The growth rate remained significantly raised for 2 yr having reached its m a x i m u m about 3 mo after injury when the growth rate was 38% in excess of normal. In fracture of the femur, the uninjured tibia shared the increase in growth rate, but with fracture of the tibia, the uninjured femur was not affected. The occurrence of the increase in growth rate and its effect in lessening leg length discrepancy must be considered when contemplating surgical correction of leg l e n g t h . - - M . G. H. Smith Fracture of the Intercondylar Eminence of the Tibia. M.-L.
Molander, G. Wallin, and 1. Wikstad. J Bone Joint Surg 63B:89-91, (February), 1981. In a series of 35 patients of whom 28 were children, a follow-up of the results of treatment of fracture of the intercondylar eminence of the tibia revealed that despite the persistence of a projection of the bone fragment in all patients this did not correlate with the degree of fracture or late symptoms. The results indicate that in most fractures conservative treatment is satisfactory.--M. G. H. Smith Postero-Medial Bowing of the Tibia: Progression of Discrepancy in Leg Lengths. A. Hofmann and D. R. Wenger.
J Bone Joint Surg 63A:384 388, (March), 1981. Thirteen children who had posteromedial bowing of the tibia were studied. The literature, to date, documents a good response to conservative therapy for this neonatal lesion, but does not discuss associated limb length discrepancy. The authors showed, by scanogram measurement, a leg length discrepancy ranging from 1.9 to 5.6 cm, with a mean of 3.1 cm. The discrepancy tended to increase with time.--Anthony H. Alter
NERVOUS SYSTEM Prenatal Detection of Neural Tube Defects. Vl. Experience With 20,000 Pregnancies. A. M. Milunsky. J A M A
244:2431-2735, (December 19), 1980. Neural tube defects (NTDs) are common, occurring in 1 in 500 pregnancies in the United States. If a previous infant has been affected the risk of recurrence is 1.5%-2%. Most of the author's experience was with otherwise normal pregnancies who were studied because of advanced maternal age and in these the neural tube defect rate was 1 of 437. He states that there have been no false negatives and that the practical false positive rate is 0.06%. He recommends that all patients at risk for N T D (previous sibling affected) have an alpha-
fetoprotein analysis of the amniotic fluid, at an early stage of pregnancy, when termination would be possible.--David L. Collins Folic Acid and Mental Symptoms in Children with Epilepsy.
M. R. Trimble, J. A. Corbett, and D. Donaldson. J Neurol Neurosurg Psychiatr 43:1030-1034, (November), 1980. Three-hundred and twelve of 314 epileptic children resident at a hospital school were examined. Anticonvulsants, especially phenytoin, lower serum folic acid levels. Children with a fall in IQ, neurotic disturbance and depression all had significantly lower serum folic acid levels than the rest of the population.--R. J. Brereton
NEOPLASMS The Epidemiology of Cancer: An Overview. D. Schottenfeld.
Cancer 47:1095-1108, (March), 1981. This is a review by one of the nations leading cancer epidemiologists. Of interest is a section on children and young adults which reflects for the first time the impact on survival rates of the impressive progress that has been made in the treatment of children with specific types of cancer (kidney, bone, acute leukemia). Mortality from childhood cancer has declined from nearly 90 per million per year in 1950, to a current level of approximately 50 per million per year. Cancer is seen in approximately 6000 children annually (U.S.). The incidence is 35% higher in males than females and significantly higher in white children. Acute leukemia and tumors of the C N S account for approximately 75% of current deaths. Testicular cancer and Ewing's sarcoma are rare among blacks in the U.S. Statistical data on additional childhood neoplasms are presented.--Daniel Hays Second Malignancy in Acute Lymphocytic Leukemia. A. D.
Mosijczuk and F. B. Ruymann. A m J Dis Child 135:313316, (April), 1981. Improved survival in childhood cancer resulting from advances in therapy is frequently associated with long term morbidity, including the potential for second malignancy. A review of the English language literature disclosed 33 cases of acute lymphocytic leukemi~ (ALL) followed by a second neoplasm. Second tumors in this group included seven cases of histiocytic medullary reticulosis, four cases of Hodgkin's disease, nine cases of acute myelocytic leukemia, four cases of chronic myelocytic leukemia, and nine cases of solid tumors. The appearance of subsequent malignancies m a y be related to a combination of therapy induced immunosuppression, a direct carcinogenic effect resulting from therapy, a n d / o r constitutional factors. Physicians should be alert to the possibility of subsequent malignant neoplasms in survivors of cancer.--J. J. Tepas Ganglioneuroblastoma of the Posterior Mediastinum: A Clinicopathologic Review of 80 Cases. A, Adam and L.
Hochholzer. Cancer 47:373-381, (January), 1981. This is a review of 80 cases of "ganglioneuroblastoma" of the posterior mediastinum from the Armed Forces Institute of Pathology. They were extracted from the 252 tumors of the sympathetic ganglia, originating in the mediastinum, and