NUMBER AND DISTRIBUTION OF MELANOCYTIC NEVI IN INDIVIDUALS WITH A HISTORY OF CHILDHOOD LEUKEMIA

BACKGROUND. An increased number of melanocytic nevi at the termination of chemotherapy has been documented in children with hematologic mali gnancies. The persistence of the increased number of nevi over time an d the relationship with personal (e.g., phenotype) and disease related variables remain to be explored. METHODS. One hundred Italian patient s diagnosed as having acute lymphatic or myeloid leukemia, after 1975, were recruited and compared with a group of 100 control individuals d rawn from friends of the enrolled patients. Information regarding life time sun exposure, phenotypic characteristics, and number of nevi was collected by experienced dermatologists. Counts of nevi were expressed both as totals and as counts per unit of body surface area (''density ''). Multiple linear regression analysis was employed to control for p otentially confounding factors when comparing patients and controls. R ESULTS. The patients and controls were fairly comparable in terms of c onstitutional characteristics, but the patients had a significantly hi gher number and density of nevi greater than or equal to 2 mm or large r in diameter. In addition, patients had a greater number of large nev i (greater than or equal to 6 mm in greatest dimension), and of nevi i n unusual areas, such as the palms and soles. Differences in nevus den sity between patients and controls were notably maintained in the olde r age group (> 12 years). None of the disease-related factors analyzed (e.g., treatment protocol and radiotherapy), appeared to be significa ntly correlated with nevus density. CONCLUSIONS. Patients with a histo ry of childhood leukemia have a sustained increase in their nevus dens ity. A fairly convincing body of evidence indicates that a large numbe r of melanocytic nevi is the strongest risk factor for melanoma. There fore, the utility of periodic skin examination of these individuals sh ould be considered. (C) 1996 American Cancer Society.