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Long‐term complication in follicular lymphoma: assessing the risk of secondary neoplasm in 242 patients treated or not with 90‐yttrium‐ibritumomab‐tiuxetan
Author(s) -
AndradeCampos Marcio Miguel,
Liévano Paola,
EspinosaLara Natalia,
SoroAlcubierre Gloria,
GrasaUlrich José María,
LópezGómez Luis,
Baringo Teresa,
Giraldo Pilar
Publication year - 2016
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.12775
Subject(s) - medicine , incidence (geometry) , international prognostic index , follicular lymphoma , retrospective cohort study , lymphoma , radiation therapy , cohort , fludarabine , surgery , radioimmunotherapy , gastroenterology , chemotherapy , rituximab , cyclophosphamide , immunology , physics , antibody , optics , monoclonal antibody
Background Non‐Hodgkin lymphoma patients have a 25% increased risk of secondary primary neoplasms ( SPNs ). Regarding the controversy about the increased risk of SPN in patients exposed to radioimmunotherapy ( RIT ), we have analyzed this issue in a cohort of follicular lymphoma ( FL ) patients treated with/without RIT . Patients and Methods A retrospective study including all consecutive FL patients diagnosed since 2001 was performed. Demographic, clinical data including the incidence of any kind of neoplasm (excluding basocellular skin carcinoma) were recorded. Results A total of 242 patients were registered, male/female: 103/139, mean age: 59.9 yr (15–86), stage IV (57.8%), and Follicular Lymphoma Prognostic Index (FLIPI) low‐risk (62.15%) predominance. Ninety‐six patients (39.7%) were treated with 90Y‐ IT . The median follow‐up for patients treated or not with 90Y‐ IT was 61 (8–273) and 38 (1–171) months. With respect to SPN incidence, 38 (15.6%) patients have at least two cancers, in 17 (44.7%), FL was the SPN ; for the rest (226), the global incidence of SPN s was 9.3% (21), but there were no differences related to the exposition or not to 90Y‐ IT ( P = 0.26). In seven patients, more than two (2–6) different therapies were registered; four were exposed to fludarabine‐based therapy, three to radiotherapy and two to autologous stem‐cell transplantation, and in the RIT cohort, two patients developed myelodysplastic syndrome. Conclusion This is one of the largest single institution reports assessing the risk of SPN in FL patients treated (96) or not (146) with 90Y‐ IT . It seems that 90Y‐ IT does not increase significantly the risk of SPN but avoiding its use after fludarabine and other intense cytotoxic schemes is recommended.