Three children treated with bone marrow transplantation for acute lymphoblastic leukemia, Diamond-Blackfan anemia, and congenital amegakaryocytic thrombocytopenia developed secondary osteosarcoma in the left tibia at the age of 13, 13, and 9 years, respectively, at 51, 117, and 106 months after transplantation, respectively. Through treatment with chemotherapy and surgery, all 3 patients are alive without disease. We surveyed the literature and reviewed 10 cases of osteosarcoma after hematopoietic stem cell transplantation (SCT), including our 3 cases. Eight of the patients had received myeloablative total body irradiation before SCT. The mean interval from SCT to the onset of osteosarcoma was 6 years and 4 months, and the mean age at the onset of osteosarcoma was 14 years and 5 months. The primary site of the post-SCT osteosarcoma was the tibia in 6 of 10 cases, in contrast to de novo osteosarcoma, in which the most common site is the femur. At least 7 of the 10 patients are alive without disease. Osteosarcoma should be one of the items for surveillance in the follow-up of patients who undergo SCT.
*Department of Pediatrics, Nagoya Medical Center, National Hospital Organization
‡Department of Orthopedic Surgery, Nagoya University Graduate School, School of Medicine, Nagoya
†Department of Pediatrics, Japanese Red Cross Narita Hospital, Narita City, Japan
The authors declare no conflict of interest.
Reprints: Hideaki Ueki, MD, Department of Pediatrics, Japanese Red Cross Narita Hospital, 90-1, Iida-cho, Narita City, Chiba Prefecture 286-8523, Japan (e-mail: firstname.lastname@example.org).
Received October 24, 2011
Accepted June 29, 2012