title: Survival of patients with chronic myeloproliferative neoplasms and new primary cancers: a population-based cohort study.
abstract: BACKGROUND
  Patients with chronic myeloproliferative neoplasms are at increased risk of new solid or haematological cancers, but how prognosis is affected in patients with preceding myeloproliferative neoplasms is unclear.
  
  
  METHODS
  We used data from population-based medical databases in Denmark from 1980 to 2011 to compare survival between cancer patients with and without a preceding diagnosis of myeloproliferative neoplasm, matched for age, sex, year of diagnosis, and type of cancer. We assessed outcomes by cancer stage and comorbidities.
  
  
  RESULTS
  Data were available for 1246 patients with a history of myeloproliferative neoplasms and we matched 5155 patients without a history of myeloproliferative neoplasm for comparison. Among patients with new localised solid cancers, 5-year survival was 49.8% (95% CI 39.1-59.6) for patients with preceding essential thrombocythaemia, 47·9% (42·1-53·4) for those with preceding polycythaemia vera, and 48.0% (34.1-60.7) for those with preceding chronic myeloid leukaemia. The values were 72.4% (68.4-76.0), 63.9% (61.5-66.2), and 74.3% (68.2-79.4), respectively, in matched patients without preceding myeloproliferative neoplasms. The risk of death among patients with a solid tumour and preceding myeloproliferative neoplasm was 1.21-2.28 times higher than in patients without myeloproliferative neoplasms. Excess mortality risk was observed irrespective of whether new cancers were diagnosed within 5 years or 5 years or more after myeloproliferative neoplasm.
  
  
  CONCLUSIONS
  Preceding myeloproliferative neoplasm is a predictor for poor outlook in patients who develop new primary cancers.
  
  
  BACKGROUND
  Lundbeck and Novo Nordisk Foundation Programme for Clinical Research Infrastructure, Danish Cancer Society, and Aarhus University Research Foundation.
authors.affiliation: Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; Department of Haematology, Odense University Hospital, Odense, Denmark. Electronic address: hef@dadlnet.dk.
authors.forename: Henrik
authors.initials: H
authors.lastname: Frederiksen
authors.affiliation: Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Dóra Körmendiné
authors.initials: DK
authors.lastname: Farkas
authors.affiliation: Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Christian Fynbo
authors.initials: CF
authors.lastname: Christiansen
authors.affiliation: Department of Haematology, Odense University Hospital, Odense, Denmark.
authors.forename: Thomas Stauffer
authors.initials: TS
authors.lastname: Larsen
authors.affiliation: Department of Haematology, Roskilde Hospital, Roskilde, Denmark.
authors.forename: Hans Carl
authors.initials: HC
authors.lastname: Hasselbalch
authors.affiliation: Department of Haematology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Jesper
authors.initials: J
authors.lastname: Stentoft
authors.affiliation: Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Henrik Toft
authors.initials: HT
authors.lastname: Sørensen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000401:mortality; D008875:Middle Aged; D009196:Myeloproliferative Disorders / Q000401:mortality*; D011087:Polycythemia Vera / Q000401:mortality; D011159:Population Surveillance; D016019:Survival Analysis; D013920:Thrombocythemia, Essential / Q000401:mortality