Increased incidence of myelodysplastic syndrome and acute myeloid leukemia following breast cancer treatment with radiation alone or combined with chemotherapy: a registry cohort analysis 1990-2005
Autor: | Judith A. Malmgren, MK Atwood, Henry G. Kaplan |
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Jazyk: | angličtina |
Předmět: |
Oncology
Adult medicine.medical_specialty Cancer Research Time Factors medicine.medical_treatment Population Breast Neoplasms Kaplan-Meier Estimate Rate ratio lcsh:RC254-282 Young Adult Breast cancer Postoperative Complications Internal medicine hemic and lymphatic diseases Antineoplastic Combined Chemotherapy Protocols medicine Genetics Humans Registries education Mastectomy Aged Aged 80 and over Leukemia Radiation-Induced education.field_of_study Radiotherapy business.industry Incidence (epidemiology) Myelodysplastic syndromes Incidence Cancer Neoplasms Second Primary Middle Aged lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens medicine.disease Combined Modality Therapy Radiation therapy Transplantation Leukemia Myeloid Acute Myelodysplastic Syndromes Female business Research Article Follow-Up Studies |
Zdroj: | BMC Cancer BMC Cancer, Vol 11, Iss 1, p 260 (2011) |
ISSN: | 1471-2407 |
DOI: | 10.1186/1471-2407-11-260 |
Popis: | Background Our objective was to measure myelodysplastic syndrome (MDS) and acute myelogenous leukemia (AML) risk associated with radiation and/or chemotherapy breast cancer (BC) treatment. Methods Our study cohort was composed of BC patients diagnosed from 1990 to 2005 and followed up for blood disorders, mean length of follow up = 7.17 years, range 2-18 years. 5790 TNM stage 0-III patients treated with surgery alone, radiation and/or chemotherapy were included. Patients without surgery (n = 111), with stem cell transplantation (n = 98), unknown or non-standard chemotherapy regimens (n = 94), lost to follow up (n = 66) or 'cancer status unknown' (n = 67) were excluded. Rates observed at our community based cancer care institution were compared to SEER incidence data for rate ratio (RR) calculations. Results 17 cases of MDS/AML (10 MDS/7 AML) occurred during the follow up period, crude rate .29% (95% CI = .17, .47), SEER comparison RR = 3.94 (95% CI = 2.34, 6.15). The RR of MDS in patients age < 65 comparing our cohort incidence to SEER incidence data was 10.88 (95% CI = 3.84, 24.03) and the RR of AML in patients age < 65 was 5.32 (95% CI = 1.31, 14.04). No significant increased risk of MDS or AML was observed in women ≥ 65 or the surgery/chemotherapy-only group. A RR of 3.32 (95% CI = 1.42, 6.45) was observed in the surgery/radiation-only group and a RR of 6.32 (95% CI = 3.03, 11.45) in the surgery/radiation/chemotherapy group. 3 out of 10 MDS cases died of disease at an average 3.8 months post diagnosis and five of seven AML cases died at an average 9 months post diagnosis. Conclusions An elevated rate of MDS and AML was observed among breast cancer patients < 65, those treated with radiation and those treated with radiation and chemotherapy compared to available population incidence data. Although a small number of patients are affected, leukemia risk associated with treatment and younger age is significant. |
Databáze: | OpenAIRE |
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