학술논문
Second Neoplasms in Italian Patients with Hairy Cell Leukemia after Treatment with Cladribine: A Multicenter Investigation and Literature Review.
Document Type
Article
Author
Criscuolo, Marianna; Tosti, Maria Elena; Broccoli, Alessandro; Varettoni, Marzia; Maraglino, Alessio Maria Edoardo; Anastasia, Antonella; Cantonetti, Maria; Trentin, Livio; Kovalchuk, Sofia; Orsucci, Lorella; Deodato, Marina; Spolzino, Angelica; Volpetti, Stefano; Annibali, Ombretta; Storti, Sergio; Stelitano, Caterina; Marchesi, Francesco; Morè, Sonia; Fianchi, Luana; Falini, Brunangelo
Source
Subject
*THERAPEUTIC use of antineoplastic agents
*LYMPHOMA diagnosis
*HAIRY cell leukemia
*RISK assessment
*DISEASE duration
*ADENOSINES
*SEX distribution
*TREATMENT effectiveness
*SURGICAL complications
*RESEARCH
*MEDICAL records
*ACQUISITION of data
*TUMOR classification
*SURVIVAL analysis (Biometry)
*SECONDARY primary cancer
*DISEASE progression
*OVERALL survival
*DISEASE risk factors
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
Language
ISSN
2072-6694
Abstract
Simple Summary: The prevalence of second neoplasms among patients with hairy cell leukemia (HCL) treated with cladribine is not negligible. Immunosuppression, high rate of cure, and aging may have a role in the pathogenesis of second cancers after HCL. We aimed to compare the risk of cancer between patients with HCL treated with cladribine and the general population. Concern has emerged about the prevalence of second cancers among patients with hairy cell leukemia (HCL) treated with purine analogs. We investigated 513 patients with HCL treated with cladribine over the last 30 years at 18 Italian centers and calculated their standardized incidence ratios (SIRs). We identified 24 patients with a second cancer diagnosed at a median time from treatment with cladribine of 59.9 months (range: 9.2–169.7 months). All patients with solid neoplasms presented with a limited-stage disease, except four cases of locally advanced cancer; multiple myeloma patients had a smoldering disease, while lymphoma patients had stage Ie and stage IV diseases. Response to therapy was complete in 19 cases; 1 patient is still receiving treatment for a relapsing bladder disease, while 2 patients progressed during treatment and died. These two patients died from unrelated causes: one from infection and one due to surgery complications. The median OS from HCL was 98.5 months (range: 38.4–409.2 months), while the median OS from second cancer was 27.6 months (range: 1–117.8 months). The SIR was 0.86 (95% CI: 0.54–1.30) for males and 1.13 (95% CI: 0.36–2.73) for females: no statistically significant differences were highlighted. We were not able to demonstrate an excess of second cancer or a significant association with the specific studied neoplasm. [ABSTRACT FROM AUTHOR]