title: Treatment outcomes and secondary cancer incidence in young patients with hairy cell leukaemia.
abstract: Repeated therapy of hairy cell leukaemia (HCL) with treatments that have potential long-term toxicities has raised concerns regarding increased risk for younger patients. We compared clinical outcomes and disease complications in 63 patients with HCL aged ≤40 years at diagnosis with 268 patients >40 years treated at Memorial Sloan Kettering Cancer Center. The rate of complete remission following initial therapy was 87% and 83% (P = 0·71) and estimated 10-year overall survival was 100% and 82% (P = 0·25) in younger and older patients, respectively. Younger patients required therapy earlier and had a significantly shorter time between first and second therapy (median: 63 months vs. 145 months) (P = 0·008). Younger patients required significantly more lines of therapy during follow-up. The 10-year cumulative incidence of secondary malignancies in young and old patients was 0·205 and 0·287, respectively (P = 0·22). The incidence of secondary cancers in patients aged >40 years at diagnosis increased with the number of treatments for HCL (P = 0·018). These results highlight that young patients with HCL have shorter responses to treatment and require more lines of therapy to maintain disease control, while attaining similar long-term survival. This has implications in the design of future clinical trials given our findings that secondary malignancies increase with more chemotherapy exposure.
authors.affiliation: Leukemia Service, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, NY, USA. b.getta@gmail.com.
authors.forename: Bartlomiej M
authors.initials: BM
authors.lastname: Getta
authors.affiliation: Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: Kaitlin M
authors.initials: KM
authors.lastname: Woo
authors.affiliation: Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: Sean
authors.initials: S
authors.lastname: Devlin
authors.affiliation: Leukemia Service, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, NY, USA.|Weill Cornell Medical College, New York, NY, USA.
authors.forename: Jae H
authors.initials: JH
authors.lastname: Park
authors.affiliation: Leukemia Service, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, NY, USA.|Weill Cornell Medical College, New York, NY, USA.
authors.forename: Omar
authors.initials: O
authors.lastname: Abdel-Wahab
authors.affiliation: Scripps Clinic, La Jolla, CA, USA.
authors.forename: Alan
authors.initials: A
authors.lastname: Saven
authors.affiliation: North Shore LIJ, New York, NY, USA.
authors.forename: Kanti
authors.initials: K
authors.lastname: Rai
authors.affiliation: Leukemia Service, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, NY, USA.|Weill Cornell Medical College, New York, NY, USA.
authors.forename: Martin S
authors.initials: MS
authors.lastname: Tallman
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007943:Leukemia, Hairy Cell / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult
keywords: hairy cell leukaemia; outcome; secondary malignancy; vemurafenib; young