Before recent improvements in therapy were available for such cancers as Wilms' tumor and neuroblastoma, children affected with these tumors almost always died before the childbearing age. The question arises: now that such children can live to bear children of their own are these progeny at increased risk of cancer, as in familial retinoblastoma? The number of long-term survivors is as yet small but at the Sidney Farber Cancer Center and the Kansas University Medical Center, no cancers have been found in 23 children whose parents survived neuroblastoma or in seven whose parents survived Wilms' tumor. Among 243 progeny whose parents had childhood cancers of various types, only two developed cancer. One had hereditary retinoblastoma (lineal transmission explained), and the other, whose mother had developed a brain tumor at 10 years, developed acute leukemia at 15 years (case not so easily explained). No children were found with congenital malformations known to be associated with certain childhood cancers (eg, hemihypertrophy in the child of a parent who survived Wilms' tumor). The authors noted that as more children survive bilateral or otherwise multifocal (hereditary) neoplasms, the frequency with which their children are affected should follow the experience with retinoblastoma.
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