title: Risk of second cancers in Waldenström macroglobulinemia.
abstract: BACKGROUND
  An increased incidence of second cancers has been reported in lymphoproliferative disorders.
  
  
  METHODS
  We assessed the frequency, characteristics and predictive factors of second cancers in 230 patients with Waldenström macroglobulinemia (WM) and compared the incidence of second cancers in WM with that of an age- and sex-matched control population.
  
  
  RESULTS
  Twenty-two patients (10%) developed solid cancers and 10 (4%) second hematologic malignancies. In a competing risk model, the cumulative incidence of solid cancers was 12% at 10 years and 17% at 15 years while the incidence of hematologic malignancies was 6% and 8%, respectively. The overall risk of second cancer in WM was 1.69 times higher than expected (P = 0.002). WM patients were at increased risk for diffuse large B-cell lymphoma [standardized incidence ratio (SIR) 9.24, P < 0.0001], myelodisplastic syndrome/acute myeloid leukemia (SIR 8.4, P < 0.0001), brain cancer (SIR 8.05, P = 0.0004). The risk of a second hematologic malignancy was fourfold higher in patients previously treated, though not reaching statistical significance (P = 0.19).
  
  
  CONCLUSIONS
  WM patients are at higher risk of second cancers as compared with the general population. The sample size does not allow firm conclusions about the effect of therapy on the development of second cancers.
authors.affiliation: Division of Hematology, Fondazione Istituto di Ricerca e Cura a Carattere Scientifico Policlinico San Matteo, University of Pavia, Pavia, Italy. m.varettoni@smatteo.pv.it
authors.forename: M
authors.initials: M
authors.lastname: Varettoni
authors.forename: A
authors.initials: A
authors.lastname: Tedeschi
authors.forename: L
authors.initials: L
authors.lastname: Arcaini
authors.forename: C
authors.initials: C
authors.lastname: Pascutto
authors.forename: E
authors.initials: E
authors.lastname: Vismara
authors.forename: E
authors.initials: E
authors.lastname: Orlandi
authors.forename: F
authors.initials: F
authors.lastname: Ricci
authors.forename: A
authors.initials: A
authors.lastname: Corso
authors.forename: A
authors.initials: A
authors.lastname: Greco
authors.forename: S
authors.initials: S
authors.lastname: Mangiacavalli
authors.forename: M
authors.initials: M
authors.lastname: Lazzarino
authors.forename: E
authors.initials: E
authors.lastname: Morra
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000453:epidemiology* / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D008258:Waldenstrom Macroglobulinemia / Q000150:complications / Q000188:drug therapy
chemical_list: D000970:Antineoplastic Agents