Incidence and time trends of second primary malignancies after non-Hodgkin lymphoma: a Swedish population-based study

Joel Kristinn Joelsson, Tove Wästerlid, Richard Rosenquist, Lasse Hjort Jakobsen, Tarec Christoffer El-Galaly, Karin Ekström Smedby, Sandra Eloranta*

*Kontaktforfatter

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

11 Citationer (Scopus)
33 Downloads (Pure)

Abstract

Considering treatment changes and an improved prognosis of non-Hodgkin lymphoma (NHL) over time, knowledge regarding long-term health outcomes, including late effects of treatment, has become increasingly important. We report on time trends of second primary malignancies (SPMs) in Swedish NHL patients, encompassing the years before as well as after the introduction of anti-CD20 antibody therapy. We identified NHL patients in the Swedish Cancer Register 1993 to 2014 and matched comparators from the Swedish Total Population Register. The matched cohort was followed through 2017. By linking to the Swedish Lymphoma Register, subcohort analyses by NHL subtype were performed. Flexible parametric survival models were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) of SPM among patients and comparators. Among 32 100 NHL patients, 3619 solid tumors and 217 myelodysplastic syndrome (MDS)/acute myeloid leukemia (AML) cases were observed, corresponding to a 40% higher rate of solid tumors (HR solid tumors 5 1.4; 95% CI, 1.4-1.5) and a 5-fold higher rate of MDS/AML (HR MDS/AML 5 5.2; 95% CI, 4.4-6.2) than for comparators. Overall, the observed excess risks for solid tumors or MDS/AML remained stable over the study period, except for follicular lymphoma, where the excess rate of MDS/AML attenuated with time (P for trend 5 .012). We conclude that NHL survivors have an increased risk of both solid tumors and hematologic malignancies, in particular MDS/AML. Stable excess risks over time indicate that contemporary treatment standards are not associated with modified SPM risk. Encouragingly, decreasing rates of MDS/AML were noted among patients with follicular lymphoma, possibly due to the increasing use of nonchemotherapy-based treatments.

OriginalsprogEngelsk
TidsskriftBlood advances
Vol/bind6
Udgave nummer8
Sider (fra-til)2657-2666
Antal sider10
ISSN2473-9529
DOI
StatusUdgivet - 26 apr. 2022

Bibliografisk note

© 2022 by The American Society of Hematology. Licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0), permitting only noncommercial, nonderivative use with attribution. All other rights reserved.

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