(HealthDay News) — Survivors of common lymphoid neoplasms have an increased risk of therapy-related myelodysplastic syndrome/acute myeloid leukemia (tMDS/AML), according to a study published in eClinicalMedicine.
The study showed an elevated risk of tMDS/AML in patients with 11 lymphoid neoplasms but no elevated risk in patients with hairy cell leukemia or cutaneous T-cell lymphoma.
The study included 186,503 adults who were treated with initial chemotherapy/immunotherapy for a first primary lymphoid neoplasm and survived 1 year or longer. There were 1496 cases of tMDS/AML in this cohort.
The researchers observed an increased risk of tMDS/AML among patients treated for:
- Precursor leukemia/lymphoma (standardized incidence ratio [SIR], 39; excess absolute risk [EAR], 30 per 10,000 person-years)
- Burkitt leukemia/lymphoma (SIR, 20; EAR, 24)
- Peripheral T-cell lymphoma (SIR, 12; EAR, 23)
- Chronic lymphocytic leukemia/small lymphocytic lymphoma (SIR, 9.0; EAR, 27)
- Mantle cell lymphoma (SIR, 8.5; EAR, 25)
- Hodgkin lymphoma (SIR, 6.9; EAR, 4.9)
- Follicular lymphoma (SIR, 6.7; EAR, 15)
- Plasma cell neoplasms (SIR, 5.4; EAR, 13)
- Diffuse large B-cell lymphoma (SIR, 5.3; EAR, 11)
- Lymphoplasmacytic lymphoma/Waldenström macroglobulinemia (SIR, 4.9; EAR, 15)
- Marginal zone lymphoma (SIR, 4.2; EAR, 9.5).
There was no elevated risk for hairy cell leukemia or mycosis fungoides/Sézary syndrome.
For patients treated more recently, the risk of tMDS/AML was significantly lower after Hodgkin lymphoma (SIR2000-2005, 15; SIR2012-2017, 6.3) and marginal zone lymphoma (SIR2000-2005, 7.5; SIR2012-2017, 2.3). However, the risk was significantly higher after chronic lymphocytic leukemia/small lymphocytic lymphoma (SIR2000-2005, 4.8; SIR2012-2017, 10).
There were no other significant differences in SIR over time. Trends for EAR and cumulative incidence were generally similar to those of SIR.
The median survival after tMDS/AML was 8.0 months in this cohort.
“Population-based data show that patients treated with initial chemo/immunotherapy for most lymphoid neoplasms may face increased tMDS/AML risks but that tMDS/AML risks have evolved consistent with changes in treatment practices for certain subtypes,” the researchers wrote.