BIRTH-DEFECTS IN OFFSPRING OF ADULT SURVIVORS OF CHILDHOOD ACUTE LYMPHOBLASTIC-LEUKEMIA - A CHILDRENS CANCER GROUP NATIONAL-INSTITUTES-OF-HEALTH REPORT

BACKGROUND. It is not known if therapy for acute lymphoblastic leukemi a (ALL) during childhood increases the risk of birth defects in the of fspring of adult survivors. The Childrens Cancer Group (CCG), in colla boration with the National Institutes of Health (NIH), conducted a ret rospective cohort study of adults successfully treated for childhood A LL to determine if their offspring had an increased incidence of birth defects compared with the offspring of their sibling controls. METHOD S. Study subjects were patients who had been enrolled on CCG ALL proto cols, who were treated for ALL prior to age 20, who survived at; least 2 years, and who were at least age 18. Survivors (N = 593) and siblin g controls (N = 409) were interviewed by telephone. RESULTS. The mean age of survivors was 22.6 years; the mean age of controls was 25.2 yea rs. Among survivors, 93 (15.7%) had given birth to or fathered a total of 140 live-born offspring, (mean age, 3.4 years), and 122 (29.8%) si bling controls had given birth to or fathered a total of 228 live-born offspring (mean age, 5.9 years). There was no difference in the rate of birth defects between offspring of survivors and offspring of contr ols (3.6% [5 of 140] vs. 3.5% [8 of 228]; relative risk, 1.02; 95% con fidence interval, 0.34, 3.05). No specific ALL therapy was associated with an increased rare of birth defects. Only female survivors reporte d offspring with birth defects (P = 0.0735). CONCLUSIONS. Adult surviv ors of childhood ALL in our study were not at greater risk for having offspring with birth defects compared with sibling controls. Although this is the largest group of ALL survivors studied to date, the number of offspring is still not large enough to detect small but significan t differences in rare events such as birth defects. Studies following this cohort into later adulthood and studies of additional ALL survivo rs are necessary to adequately quantify the risks. (C) 1996 American C ancer Society.