title: Increased prevalence of prior malignancies and autoimmune diseases in patients diagnosed with chronic myeloid leukemia.
abstract: We recently reported an increased incidence of second malignancies in chronic myeloid leukemia (CML) patients treated with tyrosine kinase inhibitors (TKI). To elucidate whether this increase may be linked, not to TKI but rather to a hereditary or acquired susceptibility to develop cancer, we estimated the prevalence of malignancies, autoimmune disease (AD) and chronic inflammatory disease (CID) in CML patients prior to their CML diagnosis. Nationwide population-based registers were used to identify patients diagnosed with CML in Sweden 2002-2012 and to estimate the prevalence of other malignancies, AD and CID prior to their CML diagnosis. For each patient with CML, five matched controls were selected from the general population. Conditional logistic regression was used to calculate odds ratios (OR). Nine hundred and eighty-four CML patients were assessed, representing more than 45 000 person-years of follow-up. Compared with matched controls, the prevalence of prior malignancies and AD was elevated in CML patients: OR 1.47 (95% confidence interval (CI) 1.20-1.82) and 1.55 (95% CI 1.21-1.98), respectively. No associations were detected between CML and previous CID. An increased prevalence of other malignancies and AD prior to the diagnosis of CML suggest that a hereditary or acquired predisposition to cancer and/or autoimmunity is involved in the pathogenesis of CML.
authors.affiliation: Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
authors.forename: N
authors.initials: N
authors.lastname: Gunnarsson
authors.affiliation: Department of Medical Science and Division of Hematology, University Hospital, Uppsala, Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Höglund
authors.affiliation: Department of Hematology, Karolinska University Hospital and Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: L
authors.initials: L
authors.lastname: Stenke
authors.affiliation: Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
authors.forename: S
authors.initials: S
authors.lastname: Wållberg-Jonsson
authors.affiliation: Regional Cancer Centre, Uppsala-Örebro, Sweden.
authors.forename: F
authors.initials: F
authors.lastname: Sandin
authors.affiliation: Department of Hematology, Karolinska University Hospital and Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Björkholm
authors.affiliation: Department of Hematology, University Hospital, Linköping, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Dreimane
authors.affiliation: Regional Cancer Centre, Uppsala-Örebro, Sweden.|Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Lambe
authors.affiliation: Department of Hematology, University Hospital, Umeå, Sweden.
authors.forename: B
authors.initials: B
authors.lastname: Markevärn
authors.affiliation: Department of Medical Science and Division of Hematology, University Hospital, Uppsala, Sweden.
authors.forename: U
authors.initials: U
authors.lastname: Olsson-Strömberg
authors.affiliation: Department of Hematology, Sahlgrenska University Hospital, Göteborg, Sweden.
authors.forename: H
authors.initials: H
authors.lastname: Wadenvik
authors.affiliation: Department of Hematology and Vascular Disorders, Skåne University Hospital, Lund, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Richter
authors.affiliation: Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Själander
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001327:Autoimmune Diseases / Q000453:epidemiology / Q000209:etiology; D016022:Case-Control Studies; D004198:Disease Susceptibility; D005260:Female; D006801:Humans; D007249:Inflammation; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000453:epidemiology* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms; D016609:Neoplasms, Second Primary / Q000453:epidemiology / Q000209:etiology; D015995:Prevalence; D012042:Registries; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult