BACKGROUND: Favorable survival in malignant cutaneous melanoma (melanoma) has increased the likelihood of second primary cancer (SPC). We assess the influence of patient characteristics at diagnosis of first melanoma and the type of SPC (second melanoma and other SPC) on overall survival. METHODS: We used the Swedish Cancer Registry data to assess overall survival in melanoma for the period 1990 to 2015. Kaplan-Meier curves were plotted and hazard ratios (HRs) were estimated with Cox regression models by considering SPC diagnosis as a time-dependent variable. RESULTS: A total of 46,726 patients were diagnosed with melanoma, and 15.3% of them developed SPC, among which, two thirds were other SPCs. Second melanomas were diagnosed early (31% during the first year) compared to non-melanoma SPCs (9.5%). Survival for women with second melanoma or other SPC (56 and 21% alive after 25 years of follow-up, respectively) exceeded the male rates (21 and 10%, respectively) but all these figures were lower than for females (60% alive) or males (48%) without SPC. Time dependent analysis showed vastly increased HRs for cancer types that are fatal also as first cancers, but SPC-specific HRs remained relatively uniform, irrespective of SPC diagnosed soon or late after first melanoma. In early-onset melanoma, SPC diagnosis after 10 years may not negatively influence overall survival. CONCLUSIONS: As the overall survival of patients with many types of SPCs is unfavorable, advice about health lifestyle should benefit smoking patients and early detection methods may be recommended for SPCs of the breast, prostate and colorectum.
- MeSH
- časové faktory MeSH
- Kaplanův-Meierův odhad MeSH
- kouření MeSH
- lidé středního věku MeSH
- lidé MeSH
- melanom mortalita MeSH
- nádory kůže mortalita MeSH
- přežívající onkologičtí pacienti statistika a číselné údaje MeSH
- proporcionální rizikové modely MeSH
- registrace MeSH
- sekundární malignity mortalita MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- sexuální faktory MeSH
- věkové faktory MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Švédsko MeSH
One out of ten patients with Philadelphia-negative myeloproliferative neoplasms (MPN) develop a second cancer (SC): in such patients we aimed at assessing the survival impact of SC itself and of MPN-specific therapies. Data were therefore extracted from an international nested case-control study, recruiting 798 patients with SC diagnosed concurrently or after the MPN. Overall, 2995 person-years (PYs) were accumulated and mortality rate (MR) since SC diagnosis was 5.9 (5.1-6.9) deaths for every 100 PYs. A "poor prognosis" SC (stomach, esophagus, liver, pancreas, lung, ovary, head-and-neck or nervous system, osteosarcomas, multiple myeloma, aggressive lymphoma, acute leukemia) was reported in 26.3% of the patients and was the cause of death in 65% of them (MR 11.0/100 PYs). In contrast, patients with a "non-poor prognosis" SC (NPPSC) incurred a MR of 4.6/100 PYs: 31% of the deaths were attributed to SC and 15% to MPN evolution. At multivariable analysis, death after SC diagnosis was independently predicted (HR and 95% CI) by patient age greater than 70 years (2.68; 1.88-3.81), the SC prognostic group (2.57; 1.86-3.55), SC relapse (1.53; 10.6-2.21), MPN evolution (2.72; 1.84-4.02), anemia at SC diagnosis (2.32; 1.49-3.59), exposure to hydroxyurea (1.89; 1.26-2.85) and to ruxolitinib (3.63; 1.97-6.71). Aspirin was protective for patients with a NPPSC (0.60; 0.38-0.95). In conclusion, SC is a relevant cause of death competing with MPN evolution. Prospective data are awaited to confirm the role of cytoreductive and anti-platelet drugs in modulating patient survival after the occurrence of a SC.
- MeSH
- hematologické nádory mortalita MeSH
- lidé středního věku MeSH
- lidé MeSH
- míra přežití MeSH
- myeloproliferativní poruchy mortalita MeSH
- následné studie MeSH
- přežití bez známek nemoci MeSH
- sekundární malignity mortalita MeSH
- senioři MeSH
- studie případů a kontrol MeSH
- věkové faktory MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- klinické zkoušky MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
The causes and rates of late patient-mortality following alloHCT for myelodysplastic syndromes or secondary acute myeloid leukemia were studied, to assess the contribution of relapse-related, treatment-related, and population factors. Data from EBMT on 6434 adults, who received a first alloHCT from January 2000 to December 2012, were retrospectively studied using combined land-marking, relative-survival methods and multi-state modeling techniques. Median age at alloHCT increased from 49 to 58 years, and the number of patients aged ≥65 years at alloHCT increased from 5 to 17%. Overall survival probability was 53% at 2 years and 35% at 10 years post-alloHCT. Survival probability at 5 years from the 2-year landmark was 88% for patients <45-year old and 63% for patients ≥65-year old at alloHCT. Cumulative incidence of nonrelapse mortality (NRM) for patients <45-year old at transplant was 7% rising to 25% for patients aged ≥65. For older patients, 31% of NRM-deaths could be attributed to population mortality. Favorable post-alloHCT long-term survival was seen; however, excess mortality-risk for all age groups was shown compared to the general population. A substantial part of total NRM for older patients was attributable to population mortality, information which aids the balanced explanation of post-HCT risk and helps improve long-term care.
- MeSH
- akutní myeloidní leukemie mortalita MeSH
- homologní transplantace mortalita MeSH
- incidence MeSH
- lidé středního věku MeSH
- lidé MeSH
- myelodysplastické syndromy mortalita MeSH
- přežití bez známek nemoci MeSH
- příčina smrti MeSH
- příprava pacienta k transplantaci mortalita MeSH
- recidiva MeSH
- retrospektivní studie MeSH
- sekundární malignity mortalita MeSH
- senioři MeSH
- transplantace hematopoetických kmenových buněk mortalita MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- MeSH
- akutní myeloidní leukemie genetika metabolismus mortalita patologie MeSH
- akutní nemoc MeSH
- analýza přežití MeSH
- dospělí MeSH
- erytroblasty metabolismus patologie MeSH
- fosfoproteiny genetika metabolismus MeSH
- kohortové studie MeSH
- kostní dřeň metabolismus patologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mutace MeSH
- myelodysplastické syndromy genetika metabolismus mortalita patologie MeSH
- nádorové proteiny genetika metabolismus MeSH
- nádorový supresorový protein p53 genetika metabolismus MeSH
- regulace genové exprese MeSH
- sekundární malignity genetika metabolismus mortalita patologie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- sestřihové faktory genetika metabolismus MeSH
- stanovení celkové genové exprese MeSH
- vysoce účinné nukleotidové sekvenování MeSH
- železo metabolismus MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- dopisy MeSH
Napriek nepopierateľným úspechom patrí alogénna transplantácia kmeňových krvotvorných buniek u detí k liečebným modalitám so zvýšeným rizikom včasných aj neskorých komplikácií. Medzi život ohrozujúce potransplantačné komplikácie vznikajúce najmenej 6 mesiacov až niekoľko rokov po diagnóze prvej malignity patria sekundárne leukémie alebo sekundárne solídne nádory. Predkladaná práca poskytuje stručný prehľad najnovších poznatkov týkajúcich sa genetických polymorfizmov súvisiacich s rizikom vzniku sekundárnych malignít. Zaoberá sa tiež skríningom sekundárnych malignít a ich manažmentom a prevenciou u pacientov po transplantácii kmeňových krvotvorných buniek v detskom veku.
There is an increased risk of early and late complications following allogeneic hematopoietic stem cell transplantation despite its demonstrated success in children. Among the life-threatening complications, which occur between 6 months and several years following the transplantation and the first diagnosis of malignancy, are secondary leukemias or secondary solid tumours. In this review we summarise relevant genetic polymorphisms associated with increased risk of secondary malignancies. Additionally, we pay specific attention to screening, management and prophylaxis in pediatric patients following hematopoietic stem cell transplantation.
- MeSH
- akutní myeloidní leukemie MeSH
- čas MeSH
- diagnostické techniky a postupy MeSH
- glutathiontransferasa MeSH
- hematopoetické kmenové buňky MeSH
- hepatocelulární karcinom MeSH
- imunosupresiva MeSH
- incidence MeSH
- jaterní cirhóza MeSH
- leukemie MeSH
- lidé MeSH
- myelodysplastické syndromy MeSH
- myeloidní leukemie * MeSH
- pediatrie MeSH
- polymorfismus genetický * MeSH
- poškození DNA MeSH
- radioterapie škodlivé účinky MeSH
- razoxan škodlivé účinky terapeutické užití MeSH
- reakce štěpu proti hostiteli MeSH
- rizikové faktory MeSH
- sekundární malignity * genetika mortalita MeSH
- směrnice pro lékařskou praxi jako téma MeSH
- statistika jako téma MeSH
- transplantace hematopoetických kmenových buněk * MeSH
- věkové faktory MeSH
- virus Epsteinův-Barrové MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- práce podpořená grantem MeSH
- přehledy MeSH
BACKGROUND: Second cancers are an important cause of mortality and morbidity in long-term survivors of testicular germ cell tumors (TGCTs). Studies on the impact of follow-up for the first tumor on the outcome of second malignancies are lacking. The aim of this study was to study the details of diagnosis of second cancers and the role of focused oncology follow-up. METHODS: Medical records and the electronic database of a tertiary referral center for germ cell neoplasms were searched for second cancers diagnosed in TGCT survivors. In a database of 1057 patients, 63 cases of metachronous second malignancies (26 contralateral testicular cancers and 37 nontesticular cancers) were found in 57 patients. Long-term oncology follow-up consisted of yearly history, physical examination, germ cell tumor markers, and imaging including abdominal computed tomography (CT) scans and chest x-ray. RESULTS: The second malignancies occurred after a medium follow-up of 9.9 years (range, 1.1-33 years) after the diagnosis of the first tumor. Only 17 (27%) of the 63 second tumors were detected by oncology follow-up investigations, and a further 12 (29%) were detected by nononcology physicians during a preplanned clinical visit. In 34 (54%) cases, patients themselves or their relatives initiated a clinical appointment because of symptoms. Follow-up investigations all had low yields for the detection of second malignancies, although CT imaging did detect several cases of cancer at an early stage. CONCLUSIONS: In this retrospective study, most second cancers occurring in long-term TGCT survivors were missed by regular oncology follow-up that included yearly physical examination, tumor marker, and imaging.
- MeSH
- adherence pacienta MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- následné studie MeSH
- přežívající MeSH
- retrospektivní studie MeSH
- sekundární malignity diagnóza mortalita patologie MeSH
- senioři MeSH
- testikulární nádory terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Klíčová slova
- malignita, screening, imunosuprese,
- MeSH
- imunosupresiva škodlivé účinky terapeutické užití MeSH
- lidé MeSH
- plošný screening metody využití MeSH
- retrospektivní studie MeSH
- sekundární malignity diagnóza epidemiologie mortalita MeSH
- transplantace jater metody statistika a číselné údaje škodlivé účinky MeSH
- Check Tag
- lidé MeSH
- MeSH
- akutní myeloidní leukemie etiologie genetika mortalita MeSH
- chromozomální aberace MeSH
- dospělí MeSH
- financování organizované MeSH
- jaderné proteiny genetika MeSH
- Kaplanův-Meierův odhad MeSH
- karyotypizace MeSH
- klinické zkoušky jako téma MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- nádory vyvolané zářením etiologie genetika mortalita MeSH
- přežití bez známek nemoci MeSH
- prognóza MeSH
- prospektivní studie MeSH
- protinádorové látky škodlivé účinky MeSH
- rizikové faktory MeSH
- sekundární malignity etiologie genetika mortalita MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- tyrosinkinasa 3 podobná fms genetika MeSH
- věkové faktory MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- souhrny MeSH
Acute myeloid leukemia (AML) is a severe condition with a high mortality. When making decisions about the optimal tailor-made therapy, numerous prognostic factors are considered. The study represents a detailed analysis of the role of these factors and treatment outcomes based on a long-term follow-up of patients treated in 5 hematology intensive care centers in the Czech Republic.The studied group comprised 1,188 patients with de novo AML and 328 patients with secondary AML. The latter were significantly older, had more unfavorable cytogenetic changes and less frequently received curative therapy. Curatively treated patients achieved fewer complete remissions and relapsed more often than those with de novo AML. Patients with secondary AML had lower rates of allogeneic transplantation as part of consolidation therapy and a significantly shorter median overall survival. A lower proportion of the patients were alive at the time of analysis. However, the treatment outcome of de novo AML patients is not satisfactory, the only exception being those with acute promyelocytic leukemia. The analysis, which did not evaluate the intention-to-treat criteria and was without randomization, found allogeneic stem cell transplantation to be the most effective modality of consolidation therapy in both groups of patients. .
- MeSH
- akutní myeloidní leukemie etiologie genetika mortalita terapie MeSH
- časové faktory MeSH
- chromozomální aberace MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- počet leukocytů MeSH
- prognóza MeSH
- sekundární malignity mortalita terapie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- transplantace hematopoetických kmenových buněk MeSH
- věkové faktory MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH