Secondary malignancies after treatment for indolent non-Hodgkin’s lymphoma: a 16-year follow-up study

Autor: Stefano Sacchi, Luigi Marcheselli, Alessia Bari, Raffaella Marcheselli, Samantha Pozzi, Stefano Luminari, Marco Lombardo, Gabriele Buda, Antonio Lazzaro, Paolo G. Gobbi, Caterina Stelitano, Fortunato Morabito, Giovanni Quarta, Maura Brugiatelli
Jazyk: angličtina
Rok vydání: 2008
Předmět:
Zdroj: Haematologica, Vol 93, Iss 3 (2008)
Druh dokumentu: article
ISSN: 0390-6078
1592-8721
DOI: 10.3324/haematol.12120
Popis: Background Relatively little information is available on the incidence of secondary cancer in non-Hodgkin’s lymphoma. The aim of this long-term follow-up study was to determine the incidence, the time free of second tumors, and risk factors for developing secondary cancer in a homogeneous group of patients with non-Hodgkin’s lymphoma.Design and Methods We evaluated a total of 563 patients with indolent non-Hodgkin’s lymphoma enrolled in Gruppo Italiano Studio Linfomi trials from 1988 to 2003.Results After a median follow-up of 62 months, 39 patients (6.9%) developed secondary cancer: 12 myelodysplastic syndromes/acute myeloid leukemia, and 27 solid tumors. The overall standardized incidence ratio of secondary malignancy in patients with non-Hodgkin’s lymphoma was higher than the risk of malignancy in the general population. The standardized incidence ratio was elevated in male patients and in patients under 65 years old at first treatment. Overall, the cumulative incidence of secondary cancer at 12 years was 10.5%, after correction in a competing-risk model. Univariate and multivariate Cox regression analyses showed that older age at the time of diagnosis, male sex, and fludarabine-containing therapy had significant negative impacts on the time free of second tumors.Conclusions We have identified subgroups of non-Hodgkin’s lymphoma patients with increased standardized incidence ratios of secondary malignancy and variables that have a negative impact on the time free of second tumors. This information could help physicians to select the most appropriate treatments. Finally, taking into account the possible occurrence of secondary neoplasia, long-term monitoring must be considered.
Databáze: Directory of Open Access Journals