Risk for death associated with a second malignancy after a primary diagnosis of chronic myeloid leukemia (CML) is increased for patients who are older or Hispanic and those having a shorter gap between diagnoses, according to results of a retrospective study published in conjunction with the 2022 ASCO Annual Meeting.

The development of a second malignancy is a major concern among cancer survivors generally. In CML, second malignancies are rare and trends remain poorly understood.

To evaluate characteristics of and determinants of survival in this patient population, investigators with the Howard-Harvard Health Sciences Outcomes Research Center, Washington, DC, and other institutions sourced data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) 18 Registry. Patient records from 1975 to 2016 were evaluated for features of and mortality from second malignancies among survivors of primary CML.

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A total of 2312 patients with CML developed a second malignancy during the study period.

The second malignancy cohort comprised 76.3% White patients, 9.6% Black patients, and 8.7% Hispanic patients, and 63.0% were men. The mean age at primary CML diagnosis was 63.2±15.6 years and at subsequent cancer diagnosis, 66.9±14.5 years.

The average latency interval between cancer diagnoses was 3.7±4.4 years.

Stratified by second malignancy, the most common cancer types were acute myeloid leukemia (12.9%) followed by prostate cancer (12.7%), lung and bronchi cancers (11.5%), and breast cancer (5.9%).

Significant predictors for mortality from the second malignancy were increasing age (hazard ratio [HR], 1.02; 95% CI, 1.01-1.03), Hispanic ethnicity (HR, 1.78; 95% CI, 1.09-2.92), and a second diagnosis latency interval shorter than 5 years (HR, 0.32; 95% CI, 0.17-0.60).

These data were sourced from medical records, and this study may have included missing or inaccurate information.

The study authors concluded that the most common second malignancy types after survival of primary CML were acute myeloid leukemia and prostate, lung, and breast cancers. Patients who were older, were Hispanic, or developed malignancy within 5 years of primary CML diagnosis had increased mortality risk.

Disclosure: One study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.


  1. Akinyemi O, Abodunrin F, Nasef KE, et al. Profile and survival outcomes among patients with second malignancies following a primary chronic myeloid leukemia: An analysis of the SEER database (1975-2016). J Clin Oncol. 2022;40(suppl 16). The American Society of Clinical Oncology abstract e19060. doi:10.1200/JCO.2022.40.16_suppl.e19060