Incidence of secondary myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML) in patients with ovarian or breast cancer in a real-world setting in the United States
| Autor: | Rahul Shenolikar, Kathleen N. Moore, G.M. Lenhart, Emily Durden, Nicole Meyer |
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| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Oncology medicine.medical_specialty medicine.medical_treatment Antineoplastic Agents Breast Neoplasms 03 medical and health sciences 0302 clinical medicine Breast cancer hemic and lymphatic diseases Internal medicine Humans Medicine Ovarian Neoplasms Chemotherapy business.industry Incidence Incidence (epidemiology) Secondary Myelodysplastic Syndrome Obstetrics and Gynecology Myeloid leukemia Cancer Neoplasms Second Primary medicine.disease Leukemia Myeloid Acute 030104 developmental biology Myelodysplastic Syndromes 030220 oncology & carcinogenesis Cohort Female business Ovarian cancer DNA Damage |
| Zdroj: | Gynecologic Oncology. 151:190-195 |
| ISSN: | 0090-8258 |
| Popis: | Objective Real-world data on patients with cancer developing secondary malignancies such as myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML) are lacking. This study assessed the incidence and impact of select DNA-damaging therapy exposure on risk of secondary MDS and AML in patients with ovarian cancer (OC) or breast cancer (BC). Methods Adults with a first observed OC or BC diagnosis (index date) between 1/1/2000 and 6/30/2014 were identified from MarketScan® Commercial and Medicare databases. Patients had ≥12 months of pre-index and ≥1 month of post-index continuous health plan enrollment. Incidence of MDS/AML was evaluated over a variable-length period following the index date for each cancer cohort. Risk factors for secondary MDS/AML, including duration of DNA-damaging therapy exposure, were assessed using Poisson regression. Results Study selection criteria identified 23,862 patients with OC and 281,473 patients with BC (mean [SD] follow-up: 35.8 [31.4] and 46.0 [37.2] months, respectively). Incidence of MDS/AML was 2.77 and 1.44 per 1000 person-years among patients with OC and BC, respectively. Within both cohorts, incidence of MDS and AML was higher among patients exposed than those not exposed to select DNA-damaging therapy (alkylating agents, antimetabolites, platinum-based antineoplastic agents, and topoisomerase inhibitors). Duration of exposure to DNA-damaging therapy was a significant risk factor for developing MDS/AML during follow-up. Conclusions Data suggest that there is likely a background risk of secondary MDS/AML associated with use of DNA-damaging therapies in earlier lines of chemotherapy and it is elevated in subcohorts exposed to select DNA-damaging therapies. |
| Databáze: | OpenAIRE |
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