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Subsequent primary malignancies and acute myelogenous leukemia transformation among myelodysplastic syndrome patients treated with or without lenalidomide.
- Source :
-
Cancer medicine [Cancer Med] 2016 Jul; Vol. 5 (7), pp. 1694-701. Date of Electronic Publication: 2016 Apr 20. - Publication Year :
- 2016
-
Abstract
- The few studies that have examined rates of acute myeloid leukemia (AML) transformation in lenalidomide-treated myelodysplastic syndrome (MDS) patients have been limited to deletion 5q MDS. The association between lenalidomide and subsequent primary malignancies (SPMs) in MDS patients has not been evaluated previously. We conducted a retrospective cohort study to evaluate the risk of both SPM and AML in association with lenalidomide. A cohort of MDS patients (n = 1248) treated between 2004 and 2012 at Moffitt Cancer Center were identified, and incident cases of SPM and AML transformation were ascertained. Using a nested case-control design, MDS controls were 1:1 matched to SPM (n = 41) and AML (n = 150) cases, on age and date of MDS diagnosis, gender, follow-up time, IPSS, and del (5q). Associations between lenalidomide and (1) SPM incidence and (2) AML transformation were estimated with hazards ratios (HR) and 95% confidence intervals (CIs) in the cohort and odds ratios (OR) in the case-control analysis. SPM incidence did not differ significantly between cohort MDS patients treated with (0.7 per 100 person-years) or without lenalidomide (1.4 per 100 person-years) (HR = 1.04, 95% CI = 0.40-2.74), whereas a significantly reduced SPM risk was observed in the case-control sample (OR = 0.03, 95% CI = <0.01-0.63). Lenalidomide was not associated with AML transformation in the cohort analysis (HR = 0.75, 95% CI = 0.44-1.27) or in the case-control analyses (OR = 1.16, 95% CI = 0.52-2.56), after adjustment for potential confounders. Lenalidomide was not associated with increased risk of SPM or AML transformation in a large cohort of MDS patients mostly including nondeletion 5q MDS.<br /> (© 2016 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)
- Subjects :
- Aged
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Case-Control Studies
Cohort Studies
Disease Progression
Female
Follow-Up Studies
Humans
Lenalidomide
Leukemia, Myeloid, Acute epidemiology
Leukemia, Myeloid, Acute mortality
Male
Middle Aged
Myelodysplastic Syndromes drug therapy
Myelodysplastic Syndromes epidemiology
Myelodysplastic Syndromes mortality
Neoplasms, Second Primary epidemiology
Neoplasms, Second Primary mortality
Registries
Retrospective Studies
Risk Factors
Thalidomide administration & dosage
Thalidomide analogs & derivatives
Antineoplastic Combined Chemotherapy Protocols adverse effects
Cell Transformation, Neoplastic
Leukemia, Myeloid, Acute etiology
Myelodysplastic Syndromes pathology
Neoplasms, Second Primary etiology
Subjects
Details
- Language :
- English
- ISSN :
- 2045-7634
- Volume :
- 5
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Cancer medicine
- Publication Type :
- Academic Journal
- Accession number :
- 27098006
- Full Text :
- https://doi.org/10.1002/cam4.721