TY - JOUR
T1 - The impact of prior malignancies on the development of second malignancies and survival in follicular lymphoma
T2 - A population-based study
AU - Dinnessen, Manette A W
AU - Visser, Otto
AU - Tonino, Sanne H
AU - van der Poel, Marjolein W M
AU - Blijlevens, Nicole M A
AU - Kersten, Marie José
AU - Lugtenburg, Pieternella J
AU - Dinmohamed, Avinash G
N1 - © 2020 The Authors. eJHaem published by British Society for Haematology and John Wiley & Sons Ltd.
PY - 2020/11
Y1 - 2020/11
N2 - We assessed the impact of a prior malignancy diagnosis (PMD) - as a potential proxy for genetic cancer susceptibility - on the development of a second primary malignancy (SPM) and mortality in follicular lymphoma (FL) patients. From the nationwide Netherlands Cancer Registry, we selected all adult FL patients diagnosed in 1994-2012 (n = 8028) and PMDs and SPMs relative to FL, with follow-up until 2017. We constructed two Fine and Gray models - with death as a competing risk - to assess the association between a PMD and SPM incidence. A PMD was associated with an increased incidence of SPMs (subdistribution hazard ratio [SHR], 1.30; 95% confidence interval [CI], 1.03-1.64) - especially carcinomas of the respiratory tract (SHR, 1.83; 95% CI, 1.10-3.05) and cutaneous squamous cell carcinomas (SHR, 1.58; 95% CI, 1.01-2.45) - and a higher risk of mortality in a multivariable model (HR, 1.43; 95% CI, 1.19-1.71). However, when additionally adjusted for the receipt of systemic therapy and/or radiotherapy before FL diagnosis, only patients who received such therapies had an increased incidence of SPMs (SHR, 1.40; 95% CI, 1.02-1.93). In conclusion, patients with a PMD had a higher rate of SPMs and mortality than those without a PMD, which might have resulted from therapy-related carcinogenesis.
AB - We assessed the impact of a prior malignancy diagnosis (PMD) - as a potential proxy for genetic cancer susceptibility - on the development of a second primary malignancy (SPM) and mortality in follicular lymphoma (FL) patients. From the nationwide Netherlands Cancer Registry, we selected all adult FL patients diagnosed in 1994-2012 (n = 8028) and PMDs and SPMs relative to FL, with follow-up until 2017. We constructed two Fine and Gray models - with death as a competing risk - to assess the association between a PMD and SPM incidence. A PMD was associated with an increased incidence of SPMs (subdistribution hazard ratio [SHR], 1.30; 95% confidence interval [CI], 1.03-1.64) - especially carcinomas of the respiratory tract (SHR, 1.83; 95% CI, 1.10-3.05) and cutaneous squamous cell carcinomas (SHR, 1.58; 95% CI, 1.01-2.45) - and a higher risk of mortality in a multivariable model (HR, 1.43; 95% CI, 1.19-1.71). However, when additionally adjusted for the receipt of systemic therapy and/or radiotherapy before FL diagnosis, only patients who received such therapies had an increased incidence of SPMs (SHR, 1.40; 95% CI, 1.02-1.93). In conclusion, patients with a PMD had a higher rate of SPMs and mortality than those without a PMD, which might have resulted from therapy-related carcinogenesis.
U2 - 10.1002/jha2.108
DO - 10.1002/jha2.108
M3 - Article
C2 - 35844986
SN - 2688-6146
VL - 1
SP - 489
EP - 497
JO - eJHaem
JF - eJHaem
IS - 2
ER -