Second malignancies following treatment of chronic myeloid leukaemia in the tyrosine kinase inhibitor era.

Abstract

Given that tyrosine kinase inhibitors (TKIs) have dramatically improved the survival of patients with chronic myeloid leukaemia (CML), we were interested in examining the possible risk of long-term adverse events, such as the emergence of other neoplasms. Therefore, we studied the development of second malignancies in 868 patients diagnosed with CML between 2002 and 2011 using the Swedish CML register, cross-linked to the Swedish Cancer register. With a median follow-up of 3·7 (range 0-9·9) years, 65 (7·5%) patients developed 75 second malignancies (non-haematological), 52 of which were of the invasive type. Compared to expected rates in the background population, the risk of second malignancies was higher in the CML cohort, with a standardized incidence ratio (SIR) of 1·52 (95% CI 1·13-1·99). The SIR before and after the second year following diagnosis of CML was 1·58 and 1·47, respectively. Among specific cancer types, gastrointestinal and nose and throat cancer were significantly increased. Founded on a population-based material, our results indicate that CML patients treated in the TKI era are at an increased risk of developing a second malignancy, with indications that this risk may more likely be linked to CML itself rather than to the TKI treatment.

• Authors: Niklas Gunnarsson, Leif Stenke, Martin Höglund, Fredrik Sandin, Magnus Björkholm, Arta Dreimane, Mats Lambe, Berit Markevärn, Ulla Olsson-Strömberg, Johan Richter, Hans Wadenvik, Jonas Wallvik, Anders Själander
• Journal: British journal of haematology (Br J Haematol) Vol. 169 Issue 5 Pg. 683-8 (Jun 2015) ISSN: 1365-2141 [Electronic] England
• PMID: 25817799 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2015 John Wiley & Sons Ltd.

Chemical References

• Antineoplastic Agents
• Protein Kinase Inhibitors

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Antineoplastic Agents (adverse effects, therapeutic use)
• Female
• Humans
• Incidence
• Leukemia, Myelogenous, Chronic, BCR-ABL Positive (drug therapy, epidemiology)
• Male
• Middle Aged
• Neoplasm Staging
• Neoplasms, Second Primary (epidemiology, etiology)
• Protein Kinase Inhibitors (adverse effects, therapeutic use)
• Registries
• Risk
• Sweden (epidemiology)
• Young Adult