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Second cancers in MPN: Survival analysis from an international study
Author(s) -
Marchetti Monia,
Ghirardi Arianna,
Masciulli Arianna,
Carobbio Alessandra,
Palandri Francesca,
Vianelli Nicola,
Rossi Elena,
Betti Silvia,
Di Veroli Ambra,
Iurlo Alessandra,
Cattaneo Daniele,
Finazzi Guido,
Bonifacio Massimiliano,
Scaffidi Luigi,
Patriarca Andrea,
Rumi Elisa,
Casetti Ilaria Carola,
Stephenson Clemency,
Guglielmelli Paola,
Elli Elena Maria,
Palova Miroslava,
Rapezzi Davide,
Erez Daniel,
Gomez Montse,
Wille Kai,
PerezEncinas Manuel,
Lunghi Francesca,
Angona Anna,
Fox Maria Laura,
Beggiato Eloise,
Benevolo Giulia,
Carli Giuseppe,
Cacciola Rossella,
McMullin Mary Frances,
Tieghi Alessia,
Recasens Valle,
Isfort Susanne,
Pane Fabrizio,
De Stefano Valerio,
Griesshammer Martin,
AlvarezLarran Alberto,
Vannucchi Alessandro Maria,
Rambaldi Alessandro,
Barbui Tiziano
Publication year - 2020
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.25700
Subject(s) - medicine , gastroenterology , multiple myeloma , cancer
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.