Cumulative Incidence of Secondary Neoplasms as a First Event After Childhood Acute Lymphoblastic Leukemia

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Abstract
Acute lymphoblastic leukemia is the most common cancer in children and adolescents, with almost 4000 new cases diagnosed in the United States each year.1 It is also one of the most curable pediatric cancers: survival rates for patients treated with contemporary risk-based protocols now exceed 80%,1-5 and most of these survivors are cured (no evidence of disease for at least 10 years).6,7 Accordingly, characterization of long-term outcomes in acute lymphoblastic leukemia patients who remain in first complete remission for at least a decade has assumed increasing importance, especially in view of the long life expectancy of this survivor population.