Epidemiologic outlook of therapy-related myeloid neoplasms and selection of high-risk patients: A Korean nationwide study
- Authors
- Ha, Hyerim; Kim, Hyo Jeong; Park, Ju Hyun; Shin, Aesun; Lee, Kyu Na; Han, Kyungdo; Lee, Na Rae; Hong, Junshik
- Issue Date
- Nov-2022
- Publisher
- WILEY
- Keywords
- acute myeloid leukemia; chemotherapy; epidemiology; myelodysplastic syndrome; radiation therapy; therapy-related neoplasms
- Citation
- CANCER, v.128, no.21, pp.3888 - 3896
- Journal Title
- CANCER
- Volume
- 128
- Number
- 21
- Start Page
- 3888
- End Page
- 3896
- URI
- http://scholarworks.bwise.kr/ssu/handle/2018.sw.ssu/43470
- DOI
- 10.1002/cncr.34453
- ISSN
- 0008-543X
- 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.
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