CML: survivors have increased risk of secondary malignancy

  • Jamy O & al.
  • Leuk Res
  • 13 May 2019

  • curated by David Reilly
  • Univadis Clinical Summaries
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Takeaway

  • Patients with chronic myeloid leukemia (CML) have significantly increased risk of developing a second malignant neoplasm (SMN).
  • Risk was highest in males and most pronounced for cancers of the respiratory tract, genitourinary (GU) tract, and skin.

Why this matters

  • As survival continues to extend in patients with CML, there is an increasing need to elucidate risk of late complications.

Study design

  • Study to investigate risk of SMNs in 3407 patients with CML.
  • Data were sourced from the Surveillance Epidemiology and End Results (SEER-18) cancer registries for patients diagnosed with CML between 2001 and 2014.
  • Funding: None.  

Key results

  • 4.99% of patients went on to develop an SMN at a median of 36.5 (range, 6-160) months following CML diagnosis.
  • Standardized incidence ratio (SIR) for SMNs was 1.40 (95% CI, 1.19-1.62).
  • Significantly increased risk of the following cancers:
    • Respiratory tract: SIR, 1.69; 95% CI, 1.15-2.4.
    • GU tract: SIR, 1.39; 95% CI, 1.04-1.81.
    • Skin cancer excluding basal cell and squamous cell carcinoma: SIR, 1.94; 95% CI, 1.04-3.32.
  • Risk of SMN was increased in males: SIR, 1.57; 95% CI, 1.29-1.88.
  • Patients with GU malignancy post-CML had inferior OS (P=.018) vs matched patients with de novo malignancy.

Limitations

  • Retrospective data.

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