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Second primary cancers in patients with acute lymphoblastic, chronic lymphocytic and hairy cell leukaemia

Zheng, Guoqiao LU ; Chattopadhyay, Subhayan LU orcid ; Sud, Amit LU ; Sundquist, Kristina LU ; Sundquist, Jan LU ; Försti, Asta LU ; Houlston, Richard ; Hemminki, Akseli and Hemminki, Kari LU (2019) In British Journal of Haematology 185(2). p.232-239
Abstract

Improvement of survival in lymphocytic leukaemia has been accompanied by the occurrence of second primary cancer (SPCs). Based on Swedish Family Cancer Database, we applied bi-directional analyses in which relative risks (RRs) were calculated for any SPCs in patients with chronic lymphocytic leukaemia (CLL), acute lymphoblastic leukaemia (ALL) and hairy cell leukaemia (HCL) and the risks of these leukaemias as SPCs. After CLL, RRs were significant for 20 SPCs, and high for skin squamous cell cancer (24·58 for in situ and 7·63 for invasive), Merkel cell carcinoma (14·36), Hodgkin lymphoma (7·16) and Kaposi sarcoma (6·76). Conversely, 15 CLL cancer pairs were reciprocally increased. The increased risks were reciprocal for ALL and four... (More)

Improvement of survival in lymphocytic leukaemia has been accompanied by the occurrence of second primary cancer (SPCs). Based on Swedish Family Cancer Database, we applied bi-directional analyses in which relative risks (RRs) were calculated for any SPCs in patients with chronic lymphocytic leukaemia (CLL), acute lymphoblastic leukaemia (ALL) and hairy cell leukaemia (HCL) and the risks of these leukaemias as SPCs. After CLL, RRs were significant for 20 SPCs, and high for skin squamous cell cancer (24·58 for in situ and 7·63 for invasive), Merkel cell carcinoma (14·36), Hodgkin lymphoma (7·16) and Kaposi sarcoma (6·76). Conversely, 15 CLL cancer pairs were reciprocally increased. The increased risks were reciprocal for ALL and four cancers. RR for ALL was 15·35 after myeloid neoplasia. HCL showed reciprocally increased RRs with non-Hodgkin lymphoma and melanoma. The concordance between RRs for bi-directional associations between CLL and different cancers, and HCL and different cancers was highly significant. For CLL (also for HCL), the bi-directional risks with skin cancers and other immune-related cancers suggest the probable involvement of immune dysfunction. For ALL, treatment may contribute to risks of multiple SPCs. Increased risk of ALL after haematological neoplasms may indicate bone marrow dysfunction. These findings may help guide treatment decisions and prognostic assessment.

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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
B cell leukaemia, bi-directional risk, immune suppression, mechanistic implication, second cancers
in
British Journal of Haematology
volume
185
issue
2
pages
232 - 239
publisher
Wiley-Blackwell
external identifiers
  • scopus:85060889672
  • pmid:30706458
ISSN
0007-1048
DOI
10.1111/bjh.15777
language
English
LU publication?
yes
id
c03e7e0d-b4a8-435e-a3de-ce4210e4f6fe
date added to LUP
2019-02-13 10:00:14
date last changed
2024-03-19 01:26:36
@article{c03e7e0d-b4a8-435e-a3de-ce4210e4f6fe,
  abstract     = {{<p>Improvement of survival in lymphocytic leukaemia has been accompanied by the occurrence of second primary cancer (SPCs). Based on Swedish Family Cancer Database, we applied bi-directional analyses in which relative risks (RRs) were calculated for any SPCs in patients with chronic lymphocytic leukaemia (CLL), acute lymphoblastic leukaemia (ALL) and hairy cell leukaemia (HCL) and the risks of these leukaemias as SPCs. After CLL, RRs were significant for 20 SPCs, and high for skin squamous cell cancer (24·58 for in situ and 7·63 for invasive), Merkel cell carcinoma (14·36), Hodgkin lymphoma (7·16) and Kaposi sarcoma (6·76). Conversely, 15 CLL cancer pairs were reciprocally increased. The increased risks were reciprocal for ALL and four cancers. RR for ALL was 15·35 after myeloid neoplasia. HCL showed reciprocally increased RRs with non-Hodgkin lymphoma and melanoma. The concordance between RRs for bi-directional associations between CLL and different cancers, and HCL and different cancers was highly significant. For CLL (also for HCL), the bi-directional risks with skin cancers and other immune-related cancers suggest the probable involvement of immune dysfunction. For ALL, treatment may contribute to risks of multiple SPCs. Increased risk of ALL after haematological neoplasms may indicate bone marrow dysfunction. These findings may help guide treatment decisions and prognostic assessment.</p>}},
  author       = {{Zheng, Guoqiao and Chattopadhyay, Subhayan and Sud, Amit and Sundquist, Kristina and Sundquist, Jan and Försti, Asta and Houlston, Richard and Hemminki, Akseli and Hemminki, Kari}},
  issn         = {{0007-1048}},
  keywords     = {{B cell leukaemia; bi-directional risk; immune suppression; mechanistic implication; second cancers}},
  language     = {{eng}},
  month        = {{01}},
  number       = {{2}},
  pages        = {{232--239}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{British Journal of Haematology}},
  title        = {{Second primary cancers in patients with acute lymphoblastic, chronic lymphocytic and hairy cell leukaemia}},
  url          = {{http://dx.doi.org/10.1111/bjh.15777}},
  doi          = {{10.1111/bjh.15777}},
  volume       = {{185}},
  year         = {{2019}},
}