Second cancers in MPN: Survival analysis from an international study

被引：34

作者：

Marchetti, Monia ^{[1
]}

Ghirardi, Arianna ^{[2
]}

Masciulli, Arianna ^{[2
]}

Carobbio, Alessandra ^{[2
]}

Palandri, Francesca ^{[3
]}

Vianelli, Nicola ^{[3
]}

Rossi, Elena ^{[4
,5
]}

Betti, Silvia ^{[5
]}

Di Veroli, Ambra ^{[6
]}

Iurlo, Alessandra ^{[7
,8
]}

Cattaneo, Daniele ^{[7
,8
]}

Finazzi, Guido ^{[9
]}

Bonifacio, Massimiliano ^{[10
]}

Scaffidi, Luigi ^{[10
]}

Patriarca, Andrea ^{[11
]}

Rumi, Elisa ^{[12
,13
]}

Casetti, Ilaria Carola ^{[13
]}

Stephenson, Clemency ^{[14
]}

Guglielmelli, Paola ^{[15
,16
]}

Elli, Elena Maria ^{[17
]}

Palova, Miroslava ^{[18
]}

Rapezzi, Davide ^{[19
]}

Erez, Daniel ^{[20
,21
,22
]}

Gomez, Montse ^{[23
]}

Wille, Kai ^{[24
]}

Perez-Encinas, Manuel ^{[25
]}

Lunghi, Francesca ^{[26
]}

Angona, Anna ^{[27
]}

Fox, Maria Laura ^{[28
]}

Beggiato, Eloise ^{[29
]}

Benevolo, Giulia ^{[30
]}

Carli, Giuseppe ^{[31
]}

Cacciola, Rossella ^{[32
]}

McMullin, Mary Frances ^{[33
]}

Tieghi, Alessia ^{[34
]}

Recasens, Valle ^{[35
]}

Isfort, Susanne ^{[36
]}

Pane, Fabrizio ^{[37
]}

De Stefano, Valerio ^{[4
,5
]}

Griesshammer, Martin ^{[24
]}

Alvarez-Larran, Alberto ^{[38
]}

Vannucchi, Alessandro Maria ^{[15
,16
]}

Rambaldi, Alessandro ^{[9
]}

Barbui, Tiziano ^{[2
]}

机构：

[1] Cardinal Massaia Hosp, Oncol Unit, Asti, Italy

[2] Papa Giovanni XXIII Hosp, FROM Res Fdn, Piazza OMS 1, I-24127 Bergamo, Italy

[3] St Orsola Marcello Malpighi Hosp, Inst Hematol L & A Seragnoli, Bologna, Italy

[4] Catholic Univ, Inst Hematol, Rome, Italy

[5] Fdn Policlin Univ A Gemelli, IRCCS, Rome, Italy

[6] Rete Laziale MPN, Rome, Italy

[7] Fdn IRCCS Ca Granda Osped Maggiore Policlin, Div Hematol, Milan, Italy

[8] Univ Milan, Milan, Italy

[9] Papa Giovanni XXIII Hosp, Div Hematol, Bergamo, Italy

[10] Univ Verona, Dept Med, Sect Hematol, Verona, Italy

[11] Univ Piemonte Orientale, Dept Translat Med, Div Hematol, Novara, Italy

[12] Fdn IRCCS Policlin San Matteo Pavia, Dept Hematol Oncol, Pavia, Italy

[13] Univ Pavia, Dept Mol Med, Pavia, Italy

[14] Guys & St Thomas NHS Fdn Trust, London, England

[15] Azienda Osped Univ Careggi, CRIMM Ctr Res & Innovat Myeloproliferat Neoplasms, Florence, Italy

[16] Univ Florence, Dept Expt & Clin Med, Florence, Italy

[17] Osped San Gerardo, ASST, Div Hematol, Monza, Italy

[18] Univ Hosp Olomouc, Dept Hematooncol, Olomouc, Czech Republic

[19] Azienda Osped S Croce & Carle, SC Ematol, Cuneo, Italy

[20] Meir Med Ctr, Hematol Inst, Kefar Sava, Israel

[21] Meir Med Ctr, Blood Bank, Kefar Sava, Israel

[22] Tel Aviv Univ, Sackler Sch Med, Tel Aviv, Israel

[23] Hosp Clin Univ, Dept Hematol, Valencia, Spain

[24] Univ Bochum, Univ Clin Hematol & Oncol Minden, Minden, Germany

[25] Univ Santiago de Compostela, Hosp Clin, Dept Hematol, Santiago De Compostela, Spain

[26] IRCCS, Hematol & Bone Marrow Transplantat Unit, San Raffaele Sci Inst, Milan, Italy

[27] Hosp del Mar, Dept Hematol, Barcelona, Spain

[28] Hosp Univ Vall dHebron, Dept Hematol, Barcelona, Spain

[29] Univ Torino, Dept Oncol, Unit Hematol, Turin, Italy

[30] Citta Salute & Sci Hosp, Div Hematol, Turin, Italy

[31] San Bortolo Hosp, Div Hematol, Vicenza, Italy

[32] Univ Catania, Policlin Vittorio Emanuele Hosp, Dept Clin & Expt Med, Haemostasis Unit, Catania, Italy

[33] Queens Univ Belfast, Ctr Med Educ, Belfast, Antrim, North Ireland

[34] Azienda Unita Sanitaria Locale IRCCS Reggio Emili, Hematol Unit, Reggio Emilia, Italy

[35] Hosp Univ Miguel Servet, Dept Hematol, Zaragoza, Spain

[36] Univ Hosp RWTH Aachen, Ctr Translat & Clin Res Aachen CTC A, Aachen, Germany

[37] Univ Naples Federico II, Hematol & Hematopoiet Stem Cell Transplant Ctr, Dept Med & Surg, Naples, Italy

[38] Hosp Clin Barcelona, Dept Hematol, Barcelona, Spain

来源：

AMERICAN JOURNAL OF HEMATOLOGY | 2020年 / 95卷 / 03期

关键词：

MYELOPROLIFERATIVE NEOPLASMS; RISK; CELL;

D O I：

10.1002/ajh.25700

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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.

引用

页码：295 / 301

页数：7

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