Increased risk of leukemia among sickle cell disease patients in California

Cancer specific survival in patients with sickle cell disease

“…As previously described, the SCD cohort was identified using longitudinal records from the California Patient Discharge Data (PDD) and the Emergency Department Utilization (EDU) databases from the Office of Statewide Health Planning and Development (OSHPD) (Adesina et al , ; Brunson et al , ,b). Since July 1990, the State of California has required that non‐Federal hospitals report up to 25 diagnoses and up to 21 procedures associated with each hospitalisation, coded using the International Classification of Disease, Ninth Revision, Clinical Modification (ICD‐9‐CM) up to 2014.…”

“…Patient sex, race/ethnicity and entry year to the cohort were obtained from the patients’ first PDD or EDU encounter. As done previously, patients with an average of ≥3 PDD or EDU encounters per year (across all study years in the cohort) were defined as having severe SCD; all other patients were defined as less severe SCD (Adesina et al , ; Brunson et al , ,b). SCD related complications were identified using specific ICD‐9‐CM codes in the PDD or EDU (Table SI).…”

“…We and others have found an increased incidence of certain cancers among SCD patients compared to general or hospitalized populations (Seminog et al, 2016;Brunson et al, 2017b). Utilizing population-based California Cancer Registry data, we recently reported that California SCD patients have a more than twofold higher incidence of leukaemia compared to the general population of California (Brunson et al, 2017b). In addition, Seminog et al (2016) reported increased cancer incidence of a number of haematological cancers, including lymphoma, leukaemia and myeloma and some solid tumours, among hospitalised SCD patients compared to controls with minor medical and surgical conditions.…”

“…Sickle cell disease (SCD), the most common inherited blood disorder in the United States, is associated with a number of serious complications, including vaso-occlusive crisis, thrombosis, stroke, acute chest syndrome and osteonecrosis of the femoral head (Platt et al, 1991;Powars et al, 2005;Adesina et al, 2017;Brunson et al, 2017a). We and others have found an increased incidence of certain cancers among SCD patients compared to general or hospitalized populations (Seminog et al, 2016;Brunson et al, 2017b). Utilizing population-based California Cancer Registry data, we recently reported that California SCD patients have a more than twofold higher incidence of leukaemia compared to the general population of California (Brunson et al, 2017b).…”

Is chronic use of hydroxyurea safe for patients with sickle cell anemia? An account of genotoxicity and mutagenicity

“…In non‐tumor cells, such as peripheral blood lymphocytes, chromosomal damage is used as a marker of genotoxic effects arising from exposure or as a consequence of neoplastic transformation [Baciuchka‐Palmaro et al, ]. Increased chromosomal damage in patients with SCA may generate a picture of genomic instability and may favor carcinogenesis, which may explain, at least in part, the increase in the occurrence of leukemia in patients with sickle cell disease compared with the general population, as reported by a recent study [Brunson et al, ]. The presence of HU increased the frequency of micronuclei in patients with SCA under treatment.…”