{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T05:59:57Z","timestamp":1772517597593,"version":"3.50.1"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T00:00:00Z","timestamp":1772496000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Neuroblastoma is the most common extracranial solid tumor in childhood. With advances in risk-adapted multimodal therapy, survival outcomes for high-risk neuroblastoma have improved substantially. However, prolonged survival has been accompanied by an increasing incidence of therapy-related second malignant neoplasms, which represent a serious late complication and a growing clinical challenge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>We report a rare case of an extremely early-onset secondary malignancy in a young child treated for high-risk neuroblastoma. A 3-year-and-4-month-old girl achieved complete remission after intensive multimodal therapy for stage IV high-risk neuroblastoma. Remarkably, only one month after completion of treatment, she developed therapy-related acute myelomonocytic leukemia (AML, FAB M4 subtype). Bone marrow evaluation revealed high-risk molecular features, including a t(9;11)(p21;q23) translocation resulting in a KMT2A\u2013MLLT3 (MLL\/AF9) fusion and concomitant EVI1 overexpression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The patient was treated with intensive AML-directed chemotherapy followed by allogeneic hematopoietic stem cell transplantation. She achieved complete hematologic and molecular remission, with sustained negativity of minimal residual disease. At the last follow-up in July 2025, she remained in continuous remission for 51 months and had returned to normal school life.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case highlights an exceptionally short latency of therapy-related AML as a second malignant neoplasm following modern intensive treatment for high-risk neuroblastoma. It underscores the need for heightened vigilance for secondary malignancies even during the early post-treatment period and emphasizes the importance of long-term surveillance strategies in neuroblastoma survivors. Early recognition and timely allogeneic transplantation may offer curative potential in selected high-risk cases. Despite the overall poor prognosis associated with therapy-related acute myeloid leukemia (t-AML), this patient achieved long-term survival following allogeneic hematopoietic stem cell transplantation, highlighting the potential for successful outcomes even in high-risk cases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1782218","type":"journal-article","created":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T05:22:41Z","timestamp":1772515361000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Therapy-related acute myeloid leukemia following successful treatment of high-risk neuroblastoma in a pediatric patient: a case report and insights into late complications"],"prefix":"10.3389","volume":"16","author":[{"given":"Si-jia","family":"He","sequence":"first","affiliation":[{"name":"Department of Pediatrics, West China Second University Hospital, Sichuan University","place":["Chengdu, 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Sichuan University","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao-yu","family":"Jing","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, West China Second University Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]},{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,3]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.24116","article-title":"New aspects of neuroblastoma treatment: ASPHO 2011 symposium review","volume":"58","author":"Zage","year":"2012","journal-title":"Pediatr Blood 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