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Second cancer in Philadelphia negative myeloproliferative neoplasms (MPN-K). A nested case-control study
T. Barbui, A. Ghirardi, A. Masciulli, A. Carobbio, F. Palandri, N. Vianelli, V. De Stefano, S. Betti, A. Di Veroli, A. Iurlo, D. Cattaneo, F. Delaini, M. Bonifacio, L. Scaffidi, A. Patriarca, E. Rumi, IC. Casetti, C. Stephenson, P. Guglielmelli,...
Language English Country Great Britain
Document type Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't
NLK
ProQuest Central
from 2000-01-01 to 1 year ago
Open Access Digital Library
from 1997-01-01
Nursing & Allied Health Database (ProQuest)
from 2000-01-01 to 1 year ago
Health & Medicine (ProQuest)
from 2000-01-01 to 1 year ago
Public Health Database (ProQuest)
from 2000-01-01 to 1 year ago
- MeSH
- Thrombocythemia, Essential drug therapy genetics MeSH
- Philadelphia Chromosome * MeSH
- Hydroxyurea adverse effects MeSH
- Humans MeSH
- Pipobroman adverse effects MeSH
- Polycythemia Vera drug therapy genetics MeSH
- Primary Myelofibrosis drug therapy MeSH
- Antineoplastic Agents adverse effects MeSH
- Pyrazoles adverse effects MeSH
- Neoplasms, Second Primary chemically induced MeSH
- Case-Control Studies MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Research Support, Non-U.S. Gov't MeSH
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.
Department of Hemato oncology University Hospital Olomouc Olomouc Czech Republic
Department of Medicine Section of Hematology University of Verona Verona Italy
Department of Molecular Medicine University of Pavia Pavia Italy
FROM Research Foundation Papa Giovanni XXIII Hospital Bergamo Italy
Guy's and St Thomas' NHS Foundation Trust London UK
Hematology and Bone Marrow Transplantation Unit IRCCS San Raffaele Scientific Institute Milano Italy
Hematology Department Hospital Clínic Barcelona Spain
Hematology Department Hospital Clínico Universitario Valencia Spain
Hematology Department Hospital del Mar Barcelona Spain
Hematology Department Hospital Universitario Miguel Servet Zaragoza Spain
Hematology Department Hospital Universitario Vall d'Hebron Barcelona Spain
Hematology Division Città della Salute e della Scienza Hospital Torino Italy
Hematology Division Ospedale San Gerardo ASST Monza Monza Italy
Hematology Division Papa Giovanni XXIII Hospital Bergamo Italy
Hematology Division San Bortolo Hospital Vicenza Italy
Hematology Unit Azienda Unità Sanitaria IRCCS di Reggio Emilia Reggio Emilia Italy
Institute of Hematology L and A Seràgnoli S Orsola Malpighi Hospital Bologna Italy
Oncology Unit Cardinal Massaia Hospital Asti Italy
S C Ematologia Azienda Ospedaliera S Croce e Carle Cuneo Italy
Unit of Hematology Department of Oncology University of Torino Torino Italy
University Clinic for Hematology and Oncology Minden University of Bochum Bochum Germany
References provided by Crossref.org
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- $a 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.
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