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Second malignancies following treatment of chronic myeloid leukaemia in the tyrosine kinase inhibitor era

Gunnarsson, Niklas; Stenke, Leif; Hoglund, Martin; Sandin, Fredrik; Bjorkholm, Magnus; Dreimane, Arta; Lambe, Mats; Markevarn, Berit; Olsson-Stromberg, Ulla and Richter, Johan LU , et al. (2015) In British Journal of Haematology 169(5). p.683-688
Abstract
Given that tyrosine kinase inhibitors (TKIs) have dramatically improved the survival of patients with chronic myeloid leukaemia (CML), we were interested in examining the possible risk of long-term adverse events, such as the emergence of other neoplasms. Therefore, we studied the development of second malignancies in 868 patients diagnosed with CML between 2002 and 2011 using the Swedish CML register, cross-linked to the Swedish Cancer register. With a median follow-up of 37 (range 0-99)years, 65 (75%) patients developed 75 second malignancies (non-haematological), 52 of which were of the invasive type. Compared to expected rates in the background population, the risk of second malignancies was higher in the CML cohort, with a... (More)
Given that tyrosine kinase inhibitors (TKIs) have dramatically improved the survival of patients with chronic myeloid leukaemia (CML), we were interested in examining the possible risk of long-term adverse events, such as the emergence of other neoplasms. Therefore, we studied the development of second malignancies in 868 patients diagnosed with CML between 2002 and 2011 using the Swedish CML register, cross-linked to the Swedish Cancer register. With a median follow-up of 37 (range 0-99)years, 65 (75%) patients developed 75 second malignancies (non-haematological), 52 of which were of the invasive type. Compared to expected rates in the background population, the risk of second malignancies was higher in the CML cohort, with a standardized incidence ratio (SIR) of 152 (95% CI 113-199). The SIR before and after the second year following diagnosis of CML was 158 and 147, respectively. Among specific cancer types, gastrointestinal and nose and throat cancer were significantly increased. Founded on a population-based material, our results indicate that CML patients treated in the TKI era are at an increased risk of developing a second malignancy, with indications that this risk may more likely be linked to CML itself rather than to the TKI treatment. (Less)
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publication status
published
subject
keywords
chronic myeloid leukaemia, treatment, malignancy
in
British Journal of Haematology
volume
169
issue
5
pages
683 - 688
publisher
Federation of European Neuroscience Societies and Blackwell Publishing Ltd
external identifiers
  • wos:000354489800009
  • scopus:84929234796
ISSN
0007-1048
DOI
10.1111/bjh.13346
language
English
LU publication?
yes
id
3d4c18e7-5f32-4cef-9bdf-e6263d8a7cc4 (old id 7411504)
date added to LUP
2015-07-03 07:03:19
date last changed
2017-11-12 03:06:53
@article{3d4c18e7-5f32-4cef-9bdf-e6263d8a7cc4,
  abstract     = {Given that tyrosine kinase inhibitors (TKIs) have dramatically improved the survival of patients with chronic myeloid leukaemia (CML), we were interested in examining the possible risk of long-term adverse events, such as the emergence of other neoplasms. Therefore, we studied the development of second malignancies in 868 patients diagnosed with CML between 2002 and 2011 using the Swedish CML register, cross-linked to the Swedish Cancer register. With a median follow-up of 37 (range 0-99)years, 65 (75%) patients developed 75 second malignancies (non-haematological), 52 of which were of the invasive type. Compared to expected rates in the background population, the risk of second malignancies was higher in the CML cohort, with a standardized incidence ratio (SIR) of 152 (95% CI 113-199). The SIR before and after the second year following diagnosis of CML was 158 and 147, respectively. Among specific cancer types, gastrointestinal and nose and throat cancer were significantly increased. Founded on a population-based material, our results indicate that CML patients treated in the TKI era are at an increased risk of developing a second malignancy, with indications that this risk may more likely be linked to CML itself rather than to the TKI treatment.},
  author       = {Gunnarsson, Niklas and Stenke, Leif and Hoglund, Martin and Sandin, Fredrik and Bjorkholm, Magnus and Dreimane, Arta and Lambe, Mats and Markevarn, Berit and Olsson-Stromberg, Ulla and Richter, Johan and Wadenvik, Hans and Wallvik, Jonas and Sjalander, Anders},
  issn         = {0007-1048},
  keyword      = {chronic myeloid leukaemia,treatment,malignancy},
  language     = {eng},
  number       = {5},
  pages        = {683--688},
  publisher    = {Federation of European Neuroscience Societies and Blackwell Publishing Ltd},
  series       = {British Journal of Haematology},
  title        = {Second malignancies following treatment of chronic myeloid leukaemia in the tyrosine kinase inhibitor era},
  url          = {http://dx.doi.org/10.1111/bjh.13346},
  volume       = {169},
  year         = {2015},
}