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In this era of modern cancer medicine, there are now 8 million to 10 million survivors of cancer in the United States, a number that increases each year. Although many survivors are "cured" of their cancer, they remain at risk for second neoplasms. The best described of the second cancers, acute leukemia, can be a consequence of the DNA-damaging therapies that are the mainstay of most chemotherapy regimens. In other cases, the risk of second neoplasms is associated not with the effects of treatment but, instead, with a hereditary predisposition to cancer. In both circumstances, the study of patients with
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