Are chronic myeloid leukemia patients more at risk for second malignancies? A population-based study.
The authors used cancer registry data to assess the incidence rate of second primary cancers among chronic myeloid leukemia (CML) patients and the long-term survival of CML patients before the introduction of tyrosine kinase inhibitors. In the Swedish Cancer Registry, the authors identified 2,753 adult CML patients diagnosed between 1970 and 1995 who were followed through December 2007. Standardized incidence ratios (SIRs) and relative survival ratios were computed. With a total of 145 subsequent primary malignancies, an increased incidence rate of second malignancy was found for stomach cancer (SIR = 2.76, 95% confidence interval (CI): 1.33, 5.08), skin cancer (SIR = 5.36, 95% CI: 3.18, 8.47), urogenital tract cancer (SIR = 1.61, 95% CI: 1.15, 2.21), and lymphoid leukemia (SIR = 5.53, 95% CI: 1.79, 12.89). Long-term relative survival figures showed that CML was related, in the era prior to the introduction of imatinib, to a very steep decline in survival (2 years from diagnosis, relative survival = 51%, 95% CI: 49, 53). This was in spite of a marginal improvement after 1985, possibly related to the introduction of interferon-α for treatment. These estimates constitute a relevant reference for future studies and a benchmark for comparisons with prognosis in CML patients after chronic use of tyrosine kinase inhibitors.
Rebora
Paola
P
Center of Biostatistics for Clinical Epidemiology, Department of Clinical Medicine and Prevention, University of Milano–Bicocca, Monza, Italy.
Czene
Kamila
K
Antolini
Laura
L
Gambacorti Passerini
Carlo
C
Reilly
Marie
M
Valsecchi
Maria Grazia
MG
D005260:Female; D006801:Humans; D015994:Incidence; D007945:Leukemia, Lymphoid / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012878:Skin Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D015996:Survival Rate; D013548:Sweden / Q000453:epidemiology; D014565:Urogenital Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality