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Although acute lymphoblastic leukemia (ALL) in childhood is highly curable, survivors are known to have a slightly increased risk for developing a second cancer at 15 to 20 years. The longer-term risk is less clear, however.
The 2169 patients in this retrospective study experienced complete ALL remission as children and were followed for a median of 19 years (range, 2–41 years). Their risk for second cancers was compared with the risk for cancer among the general population. Overall, 168 patients (7.7%) developed secondary cancers; of the 1290 patients who remained in remission, 123 (9.5%) developed secondary cancers. The cumulative incidence, which was initially low (4%–5% in the first 15–20 years), rose through as long as 30 years of follo…