title: Long-term follow up of rates of secondary malignancy and late relapse of two trials using radioimmunotherapy consolidation following induction chemotherapy for previously untreated indolent lymphoma.
abstract: Existing data suggest that myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML) peak in incidence 5-10 years following exposure to ionizing radiation, while most publications report less than 5 years of follow-up after radioimmunotherapy (RIT). We report the rate of secondary MDS/AML among 60 patients treated with two front-line sequential chemotherapy-RIT trials with over 11 years of follow-up. Among 35 patients evaluated after fludarabine-RIT and 25 patients evaluated after CVP (cyclophosphamide, vincristine, prednisone)-RIT treatment, the crude, cumulative and Kaplan-Meier rates of MDS/AML at 11 years of follow-up from the combined trials were 0.12/person, 0.010/person-year and 14% (95% confidence interval [CI] 5-24%), respectively. Additionally, we found that patients treated with RIT consolidation appear to have durable remissions but that relapses after 10 years do occur. Studies of efficacy and secondary MDS/AML that report fewer than 10 years of follow-up likely underestimate risk.
authors: a Center for Lymphoma and Myeloma, Division of Hematology/Oncology, Weill Cornell Medical College , New York , NY , USA.
authors: Jonathan
authors: J
authors: Reiss
authors: b University of Iowa Hospitals and Clinics , Iowa City , IA , USA.
authors: Brian
authors: B
authors: Link
authors: a Center for Lymphoma and Myeloma, Division of Hematology/Oncology, Weill Cornell Medical College , New York , NY , USA.
authors: Jia
authors: J
authors: Ruan
authors: a Center for Lymphoma and Myeloma, Division of Hematology/Oncology, Weill Cornell Medical College , New York , NY , USA.
authors: Richard
authors: R
authors: Furman
authors: a Center for Lymphoma and Myeloma, Division of Hematology/Oncology, Weill Cornell Medical College , New York , NY , USA.
authors: Morton
authors: M
authors: Coleman
authors: a Center for Lymphoma and Myeloma, Division of Hematology/Oncology, Weill Cornell Medical College , New York , NY , USA.
authors: John
authors: J
authors: Leonard
authors: a Center for Lymphoma and Myeloma, Division of Hematology/Oncology, Weill Cornell Medical College , New York , NY , USA.
authors: Peter
authors: P
authors: Martin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D001706:Biopsy; D001853:Bone Marrow / Q000473:pathology; D017322:Clinical Trials, Phase II as Topic; D017326:Clinical Trials, Phase III as Topic; D060830:Consolidation Chemotherapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D060828:Induction Chemotherapy; D053208:Kaplan-Meier Estimate; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000401:mortality; D008223:Lymphoma / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000401:mortality; D016609:Neoplasms, Second Primary / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology* / Q000401:mortality; D016499:Radioimmunotherapy / Q000009:adverse effects / Q000379:methods; D012008:Recurrence; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Radioimmunotherapy; acute myeloid leukemia; follicular lymphoma; myelodysplastic syndrome