Risk of second primary malignancies in a population-based study of adult patients with essential thrombocythemia

Shrestha, Rajendra; Giri, Smith; Pathak, Ranjan; Bhatt, Vijaya Raj

doi:10.5306/wjco.v7.i4.324

Cited by 9 publications

(8 citation statements)

References 31 publications

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“…For example, in the study by Chattopadhyay et al, the relative increase in second cancer risk was highest in MPN patients aged ≤ 65 years, with IRRs ranging from 1.7- to 3.7-fold elevated in patients with ET, PV, MF and MPN-U, whereas the IRRs ranged from 1.3- to 1.8-fold elevated in patients aged > 65 years [ 13 ]. The same tendency was seen in other studies, with SIRs for second cancer of 1.8 for PV patients aged ≤ 60 years and 1.2 in patients aged > 60 years [ 23 ]; or ET patients with SIRs of 1.8 and 1.2 for ages ≤ 60 years and > 60 years, respectively [ 28 ]. In the study by Landtblom et al, the overall cumulative incidence of cancer increased with increasing age for both patients and matched comparisons [ 11 ].…”

Section: Resultssupporting

confidence: 84%

“…We found that for patients with ET, SIRs for cancer incidence diminished during the first 5 years following diagnosis, whereas the opposite was seen in patients with PV and CML [ 10 ]. Shresta and colleagues reported on insignificant increases in SIR for solid cancer two years after ET diagnosis [ 28 ]. Landtblom et al showed that HRs for any solid cancer and for non-melanoma skin cancer decreased steeply during the first year and gradually increased thereafter [ 11 ].…”

Section: Resultsmentioning

confidence: 99%

“…All studies found that although the absolute number of MPN patients with a second cancer increased with age, the increase relative to the general population was largest in the youngest age groups, reaching a 1.8- to 4.2-fold elevation [ 9 , 10 , 11 , 23 , 28 ]. For example, in the study by Chattopadhyay et al, the relative increase in second cancer risk was highest in MPN patients aged ≤ 65 years, with IRRs ranging from 1.7- to 3.7-fold elevated in patients with ET, PV, MF and MPN-U, whereas the IRRs ranged from 1.3- to 1.8-fold elevated in patients aged > 65 years [ 13 ].…”

Section: Resultsmentioning

confidence: 99%

“…Either these were high incidence cancers (e.g., breast cancer, colorectal cancer, prostate cancer, and lung cancer) or cancer types that have been reported with an elevated risk in patients with MPN (e.g., skin cancer, kidney cancer, and thyroid cancer). Among the included 12 studies, eight reported on risks of both solid and lymphoid malignancies [ 9 , 10 , 11 , 13 , 22 , 23 , 28 , 29 ], two studies reported on risks of lymphoid malignancies only [ 24 , 26 ], and one study reported on risks of solid cancer only [ 25 ] ( Table 1 and Table 2 ). Additionally, one study reporting on prognosis among patients with a second cancer and MPN as the primary cancer compared to matched patients with the same cancers but without MPN was included [ 27 ] ( Table 3 ).…”

Section: Methodsmentioning

confidence: 99%

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Risks of Solid and Lymphoid Malignancies in Patients with Myeloproliferative Neoplasms: Clinical Implications

Brabrand

Frederiksen

2020

Cancers

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In the past decade, several studies have reported that patients with chronic myeloproliferative neoplasms (MPNs) have an increased risk of second solid cancer or lymphoid hematological cancer. In this qualitative review study, we present results from studies that report on these cancer risks in comparison to cancer incidences in the general population or a control group. Our literature search identified 12 such studies published in the period 2009–2018 including analysis of more than 65,000 patients. The results showed that risk of solid cancer is 1.5- to 3.0-fold elevated and the risk of lymphoid hematological cancer is 2.5- to 3.5-fold elevated in patients with MPNs compared to the general population. These elevated risks apply to all MPN subtypes. For solid cancers, particularly risks of skin cancer, lung cancer, thyroid cancer, and kidney cancer are elevated. The largest difference in cancer risk between patients with MPN and the general population is seen in patients below 80 years. Cancer prognosis is negatively affected due to cardiovascular events, thrombosis, and infections by a concurrent MPN diagnosis mainly among patients with localized cancer. Our review emphasizes that clinicians caring for patients with MPNs should be aware of the very well-documented increased risk of second non-myeloid cancers.

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Section: Resultssupporting

confidence: 84%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Risks of Solid and Lymphoid Malignancies in Patients with Myeloproliferative Neoplasms: Clinical Implications

Brabrand

Frederiksen

2020

Cancers

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“…Registry studies from Europe and US consistently reported non‐MPN cancers in about 17% of patients with MPN: a 20%‐40% higher risk of non‐MPN cancers was reported in the years preceding and following the diagnosis of MPN . In particular, the standardized risk of non‐Hodgkin's lymphomas was reported to be 1.8 (1.1–2.7) in the Danish registry, 4.52 (2.26‐0.09) in the Florence database, 1.1 (0.55‐1.88), and 1.59 (0.82‐2.78) for PV and ET, respectively, in the SEER database . Nevertheless, the above four studies could analyze only 56 overall patients with both MPN and LPD.…”

Section: Discussionmentioning

confidence: 97%

Lymphoproliferative disorders in patients with chronic myeloproliferative neoplasms: A systematic review

et al. 2018

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Patients with a Ph-negative myeloproliferative neoplasm (MPN) may harbor or develop lymphoproliferative disorders (LPD), however, the clinical and molecular determinants of MPN and LPD co-occurrence are still uncertain. To systematically pool the available knowledge, we conducted a scoping review of literature published since January 2005 and analyzed single-patient clinical data from 50 papers reporting 214 individuals harboring both MPN and LPD. Patients had been diagnosed essential thrombocythemia (44%), polycythemia vera (29%), or myelofibrosis (23%) at a median age of 67 years (26-94): half of them incurred a LPD after a median of 72 months from MPN diagnosis, while in 20% the LPD diagnosis was antecedent or synchronous. Patients mainly incurred indolent LPD, particularly chronic lymphocytic leukemia (CLL), while aggressive lymphomas and multiple myeloma were a relevant portion of the LPDs occurring in the follow-up of MPN. CLL was preferentially diagnosed in PV patients and was associated with a very high male-to-female ratio, as well as an older age at MPN diagnosis. On converse, multiple myeloma was rarely reported in PV patients and was preferentially diagnosed in female patients not harboring the JAK2 V617F mutation. Based on the 46 cases reporting follow-up data, median survival after MPN diagnosis was 96 months. This thorough review of published evidence confirms that LPD are relevant clinical events in the history of MPN patients. Controlled studies are needed to better refine individuals at higher risk of developing LPD, to support surveillance programs and to avoid therapies possibly favoring LPD.

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Incidence and risk factors for second malignancies among patients with myeloproliferative neoplasms

et al. 2023

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Objective The clinical characteristics and survival of patients with myeloproliferative neoplasms (MPNs) with secondary cancer were analyzed to explore the possible risk factors for secondary cancer in MPN patients. Methods The clinical characteristics of 1060 Chinese patients with MPN were retrospectively analyzed. The Kaplan–Meier method was used to analyze the survival. The Cox multivariate regression model was used to analyze the risk factors for developing secondary cancer in patients with MPNs. Results The 1060 patients with MPN had a median follow‐up of 10 years (range 1–50) and a median age of 55 years (range 21–86), and 497 (45.2%) were male. The proportion of PV, ET, and PMF was 52.2%, 33.5%, and 14.3%, respectively. About 28.1% (298/1060) of 1060 MPN patients died. The median survival times of the PV, ET, and PMF groups were 20, 24, and 12 years, respectively ( p < 0.0001). In age‐ and sex‐matched healthy Chinese patients, the standardized incidence ratio (SIR) value of developing secondary cancer in MPN patients was 6.41 (95% CI: 4.90–9.48). The median survival time was 14 years in the MPN with secondary cancer group. The Cox multivariate analysis showed that age ≥ 65 years ( p < 0.0001, HR = 5.027, 95% CI [2.823, 8.952]), MF‐1 ( p = 0.001, HR = 2.887, 95% CI [1.503, 5.545]) were risk factors for developing secondary cancer. Conclusions The survival of MPN patients with secondary cancer was significantly worse than that of patients without secondary cancer. Compared with normal subjects, MPN patients had a 6.41‐fold increased risk of developing secondary cancer, and age ≥ 65 years and MF‐1 were risk factors for developing secondary cancer in MPN patients.

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Risk of second primary malignancies in a population-based study of adult patients with essential thrombocythemia

Cited by 9 publications

References 31 publications

Risks of Solid and Lymphoid Malignancies in Patients with Myeloproliferative Neoplasms: Clinical Implications

Risks of Solid and Lymphoid Malignancies in Patients with Myeloproliferative Neoplasms: Clinical Implications

Lymphoproliferative disorders in patients with chronic myeloproliferative neoplasms: A systematic review

Incidence and risk factors for second malignancies among patients with myeloproliferative neoplasms

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