Translocation kidney cancer after chemotherapy in childhood

This article out of Johns Hopkins reviewed the risk of renal cell carcinoma occurring as a secondary malignancy after chemotherapy in childhood.

It is known that children who survive cancer are at the risk of developing another malignancy 20 times more likely than the general population. This study described the clinical, pathologic, cytogenetic, and molecular data on six translocation renal cell carcinomas that arose in five patients who had received chemotherapy.

At the time of diagnosis, the children were between the ages of 6-22 years. Histologically, the tumor showed typical features that are described for translocation renal cell carcinomas. At the molecular level, three of the tumors contained the ASPL-TFE3 fusion; two contained Alpha-TFEB and one contained PRCC-TFE3. The time span between chemotherapy and the diagnosis of these renal cell carcinomas ranged from 4-13 years. The indications varied and including acute promyelocytic leukemia, acute myeloid leukemia, bilateral Wilms' tumor, systemic lupus erythematosus, and a conditioning regimen of bone marrow transplantation secondary to Hurler's syndrome. This latter patient also received radiation.

The group had 39 genetically confirmed translocation renal cell carcinomas in their experience with six (15%) of these arising in patients who received cytotoxic chemotherapy. They make the conclusion that cytotoxic chemotherapy may predispose patients to the development of renal translocation carcinomas.

Argani P, Lae M, Ballard ET, Amin M, Manivel C, Hutchinson B, Reuter VE, Ladanyi M.

Urological Oncology: Seminars and Original Investigation 24 (6): 558-559, December 2006.

By Pasquale Casale, MD