TY - JOUR
T1 - Second cancer in Philadelphia negative myeloproliferative neoplasms (MPN-K). A nested case-control study
AU - Barbui, Tiziano
AU - Ghirardi, Arianna
AU - Masciulli, Arianna
AU - Carobbio, Alessandra
AU - Palandri, Francesca
AU - Vianelli, Nicola
AU - De Stefano, Valerio
AU - Betti, Silvia
AU - Di Veroli, Ambra
AU - Iurlo, Alessandra
AU - Cattaneo, Daniele
AU - Delaini, Federica
AU - Bonifacio, Massimiliano
AU - Scaffidi, Luigi
AU - Patriarca, Andrea
AU - Rumi, Elisa
AU - Casetti, Ilaria Carola
AU - Stephenson, Clemency
AU - Guglielmelli, Paola
AU - Elli, Elena Maria
AU - Palova, Miroslava
AU - Bertolotti, Laura
AU - Erez, Daniel
AU - Gomez, Montse
AU - Wille, Kai
AU - Perez-Encinas, Manuel
AU - Lunghi, Francesca
AU - Angona, Anna
AU - Fox, Maria Laura
AU - Beggiato, Eloise
AU - Benevolo, Giulia
AU - Carli, Giuseppe
AU - Cacciola, Rossella
AU - McMullin, Mary Frances
AU - Tieghi, Alessia
AU - Recasens, Valle
AU - Marchetti, Monia
AU - Griesshammer, Martin
AU - Alvarez-Larran, Alberto
AU - Vannucchi, Alessandro Maria
AU - Finazzi, Guido
PY - 2019/5/29
Y1 - 2019/5/29
N2 - We conducted a large international nested case-control study including 1881 patients with Philadelphia-negative myeloproliferative neoplasms (MPN). Cases (n = 647) were patients with second cancer (SC: carcinoma, non-melanoma skin cancer, hematological second cancer, and melanoma) and controls (n = 1234) were patients without SC, matched with cases for sex, age at MPN diagnosis, date of MPN diagnosis, and MPN disease duration. The aim was to evaluate the risk of SC after exposure to cytoreductive drugs. Patients exposed to hydroxyurea (HU) (median: 3 years) had a risk of SC similar to unexposed patients (OR = 1.06, 95% CI 0.82-1.38). In contrast, in cancer-specific stratified multivariable analysis, HU had two-fold higher risk of non-melanoma (NM) skin cancer (OR = 2.28, 95% CI 1.15-4.51). A significantly higher risk of NM-skin cancer was also documented for pipobroman (OR = 3.74, 95% CI 1.00-14.01), ruxolitinib (OR = 3.87, 95% CI 1.18-12.75), and for drug combination (OR = 3.47, 95% CI 1.55-7.75). These three drugs did not show excess risk of carcinoma and hematological second cancer compared with unexposed patients. Exposure to interferon, busulfan, and anagrelide did not increase the risk. In summary, while it is reassuring that no excess of carcinoma was documented, a careful dermatologic active surveillance before and during the course of treatments is recommended.
AB - We conducted a large international nested case-control study including 1881 patients with Philadelphia-negative myeloproliferative neoplasms (MPN). Cases (n = 647) were patients with second cancer (SC: carcinoma, non-melanoma skin cancer, hematological second cancer, and melanoma) and controls (n = 1234) were patients without SC, matched with cases for sex, age at MPN diagnosis, date of MPN diagnosis, and MPN disease duration. The aim was to evaluate the risk of SC after exposure to cytoreductive drugs. Patients exposed to hydroxyurea (HU) (median: 3 years) had a risk of SC similar to unexposed patients (OR = 1.06, 95% CI 0.82-1.38). In contrast, in cancer-specific stratified multivariable analysis, HU had two-fold higher risk of non-melanoma (NM) skin cancer (OR = 2.28, 95% CI 1.15-4.51). A significantly higher risk of NM-skin cancer was also documented for pipobroman (OR = 3.74, 95% CI 1.00-14.01), ruxolitinib (OR = 3.87, 95% CI 1.18-12.75), and for drug combination (OR = 3.47, 95% CI 1.55-7.75). These three drugs did not show excess risk of carcinoma and hematological second cancer compared with unexposed patients. Exposure to interferon, busulfan, and anagrelide did not increase the risk. In summary, while it is reassuring that no excess of carcinoma was documented, a careful dermatologic active surveillance before and during the course of treatments is recommended.
U2 - 10.1038/s41375-019-0487-8
DO - 10.1038/s41375-019-0487-8
M3 - Article
C2 - 31142846
SN - 0887-6924
JO - Leukemia
JF - Leukemia
ER -