Acute myeloid leukemia after breast cancer: a population-based comparison with hematological malignancies and other cancers.
BACKGROUND
Clinical trials frequently report acute myeloid leukemia (AML) as a complication of adjuvant chemotherapy for breast cancer (BC).


METHODS
This retrospective population-based study investigated AML risk after a prior BC diagnosis and compared the results with women after a prior diagnosis of hematological malignancies (HM), other cancers combined (OCC), and the age-matched Australian female population.


RESULTS
Women with a prior BC diagnosis had 2.56 times the risk of developing AML compared with the Australian female population (P<0.001). AML risk was also elevated after prior HM and OCC diagnoses (4.73, P<0.001, and 1.70, P<0.001, respectively). Although the incidence of AML rose sharply with age in all cohorts, the age-specific relative risk was highest in the 30- to 49-age-group and decreased with increasing age. AML risk increased with the duration of follow-up but there was no change of risk during the 23 years of this study.


CONCLUSIONS
AML risk was elevated after a prior diagnosis of BC but there was no evidence of an increasing risk of AML after a BC diagnosis or, in any of the other cancer cohorts, during this era of expansion of the evidence base for more intensive treatments.
Beadle
G
G
Department of Translational Research Laboratory, Queensland Institute of Medical Research, Brisbane, Australia. geoffBe@qimr.edu.au
Baade
P
P
Fritschi
L
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001315:Australia / Q000453:epidemiology; D001943:Breast Neoplasms / Q000188:drug therapy / Q000453:epidemiology*; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D019337:Hematologic Neoplasms / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D015994:Incidence; D015470:Leukemia, Myeloid, Acute / Q000453:epidemiology* / Q000209:etiology; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000453:epidemiology* / Q000209:etiology; D012189:Retrospective Studies