Epidemiologic outlook of therapy‐related myeloid neoplasms and selection of high‐risk patients: A Korean nationwide study. Issue 21 (7th September 2022)

• Record Type: Journal Article
• Authors: Ha, Hyerim; Kim, Hyo Jeong; Park, Ju Hyun; Shin, Aesun; Lee, Kyu Na; Han, Kyungdo; Lee, Na Rae; Hong, Junshik
• Is Part Of: Cancer. Volume 128:Issue 21(2022)
• Page Start: 3888
• Page End: 3896
• Publication Date: 2022-09-07
• Subjects: acute myeloid leukemia -- chemotherapy -- epidemiology -- myelodysplastic syndrome -- radiation therapy -- therapy‐related neoplasms; Cancer -- Periodicals; Cancer -- Cytopathology -- Periodicals; 616.99405
• DOI: 10.1002/cncr.34453
• Languages: English
• ISSNs: 0008-543X

Abstract

Abstract : Background: Although a considerable proportion of patients with cancer receive chemotherapy (CT) or radiotherapy (RT), only a very few patients eventually develop therapy‐related myeloid neoplasms (t‐MNs). Methods: To identify subsets of cancer patients who have substantially elevated risk of developing t‐MNs. Incidences and risks of t‐MNs after contemporary CT or RT in patients newly diagnosed major cancers during 2009–2013 were analyzed. By merging two Korean nationwide health care big data sets, patients were selected and observed on follow‐up to until t‐MN development or December 2019. Results: Among 250, 155 patients, 555 (0.22%) were diagnosed with t‐MNs with a standard incidence ratio (SIR) of 3.40 (95% CI, 3.13–3.70). Patients had bone/joint cancers (SIR, 94.25; 95% CI, 50.71–137.80) and a remarkably high SIR for t‐MN development. Patients receiving both CT and RT had the highest SIR (4.64; 95% CI, 4.08–5.20), followed by those receiving CT only (SIR, 3.30; 95% CI, 2.89–3.70). Contrarily, RT alone did not increase t‐MN risk (SIR, 1.16; 95% CI, 0.76–1.56). More exposure to leukemogenic agents resulted in the higher t‐MNs development. Conclusions: The increased risk of developing acute myeloid leukemia or myelodysplastic syndrome after CT and/or RT was confirmed and subsets with substantially elevated risk for developing t‐MNs were found. Such patients would be suitable for a prospective cohort for investigating t‐MN pathogenesis by time series analyses. Abstract : Patients with bone/joint cancers have a substantially elevated risk of developing therapy‐related myeloid neoplasms (t‐MNs). Radiation increases the risk of developing t‐MNs when added to chemotherapy but does not if it is used alone.