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Second malignancies in patients with myeloproliferative neoplasms: a population-based cohort study of 9379 patients

Leukemia volume 32, pages 2203–2210 (2018)Cite this article

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Abstract

To determine the risk of a wide range of second malignancies in patients with myeloproliferative neoplasms (MPNs), we conducted a large population-based study and compared the results to matched controls. From national Swedish registers, 9379 patients with MPNs diagnosed between 1973 and 2009, and 35,682 matched controls were identified as well as information on second malignancies, with follow-up until 2010. Hazard ratios (HRs) with 95 % confidence intervals (CIs) were calculated using Cox regression and a flexible parametric model. There was a significantly increased risk of any non-hematologic cancer with HR of 1.6 (95% CI: 1.5–1.7). The HRs for non-melanoma skin cancer was 2.8 (2.4–3.3), kidney cancer 2.8 (2.0–4.0), brain cancer 2.8 (1.9–4.2), endocrine cancers 2.5 (1.6–3.8), malignant melanoma 1.9 (1.4–2.7), pancreas cancer 1.8 (1.2–2.6), lung cancer 1.7 (1.4–2.2), and head and neck cancer 1.7 (1.2–2.6). The HR of second malignancies was similar across all MPN subtypes, sex, and calendar periods of MPN diagnosis. The risk of developing a hematologic malignancy was also significantly increased; the HR for acute myeloid leukemia was 46.0 (32.6–64.9) and for lymphoma 2.6 (2.0–3.3). In conclusion, our study provides robust population-based support of an increased cancer risk in MPN patients.

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Acknowledgements

We thank the “Swedish Initiative for research on Microdata in the Social and Medical sciences” (SIMSAM) and Rozita Broumandi for valuable assistance in collecting the information from the Swedish registers.

Author contributions

Conception and design: ARL, HB, TM-LA, MH. Collection and assembly of data: ARL, HB, TM-LA, PWD, MB, SYK, MH. Data analysis and interpretation: All authors. Manuscript writing: All authors. Final approval of manuscript: All authors. Research funding: The regional agreement on medical training and clinical research (ALF) between Stockholm County Council and Karolinska Institutet, Blodcancerfonden, The Cancer Research Foundations of Radiumhemmet, The Adolf H. Lundin Charitable Foundation, The Memorial Sloan Kettering Core Grant (P30 CA008748), Swedish Cancer Society.

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Authors and Affiliations

  1. Department of Medicine, Division of Hematology, Stockholm South Hospital and Karolinska Institutet, Stockholm, Sweden

    Anna Ravn Landtblom & Jan Samuelsson

  2. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden

    Hannah Bower, Therese M.-L. Andersson & Paul W. Dickman

  3. Department of Medicine, Division of Hematology, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden

    Magnus Björkholm, Sigurdur Yngvi Kristinsson & Malin Hultcrantz

  4. Faculty of Medicine, University of Iceland and Department of Hematology, Landspitali National University Hospital, Reykjavik, Iceland

    Sigurdur Yngvi Kristinsson

  5. Department of Medicine, Myeloma Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    Malin Hultcrantz

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  1. Anna Ravn Landtblom
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Correspondence to Anna Ravn Landtblom.

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Additional information

This study was previously presented in part as an oral contribution at European Hematology Association 21st Congress 10th June, 2016 Copenhagen, Denmark.

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Landtblom, A.R., Bower, H., Andersson, T.ML. et al. Second malignancies in patients with myeloproliferative neoplasms: a population-based cohort study of 9379 patients. Leukemia 32, 2203–2210 (2018). https://doi.org/10.1038/s41375-018-0027-y

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