Risk for Second Primary Malignancy Up in CLL Survivors

SPM risk higher for men and nonwhites, after chemotherapy, for recent years of diagnosis, for advanced age

FRIDAY, Nov. 1, 2019 (HealthDay News) -- Survivors of chronic lymphocytic leukemia (CLL) have an increased risk for second primary malignancy (SPM), according to a study published online Sept. 30 in Blood Cancer Journal.

Vivek Kumar, M.D., from Harvard Medical School in Boston, and colleagues compared differences in risk for SPMs among CLL survivors from the Surveillance, Epidemiology, and End Results database (1973 to 2015) to the risk for individual malignancies expected in the general population.

The researchers found that 6,487 new SPMs were diagnosed in about 270,000 person-years of follow-up, for a standardized incidence ratio (SIR) of 1.2. Higher risk was seen for both solid and hematologic malignancies (SIRs, 1.15 and 1.61, respectively). The highest risk for SPMs was seen between two and five months after CLL diagnosis (SIR, 1.57) and for patients aged 50 to 79 years. Compared with 1973 to 1982, there was a significant increase in SPMs in 2003 to 2015 (SIRs, 1.36 versus 1.19, respectively). CLL patients who had received prior chemotherapy had higher a risk for SPM (SIR, 1.38) compared with those untreated or those with treatment status unknown (SIR, 1.16). The risk for developing SPMs was increased among men, after chemotherapy, for recent years of diagnosis, for advanced age, and for nonwhites in multivariate analysis.

"We demonstrate trends in the incidence of SPMs among patients with CLL," the authors write. "This could inform further studies about the etiology of SPMs and help shape improved survivorship for patients with CLL."

Several authors disclosed financial ties to the pharmaceutical industry.

Abstract/Full Text

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