Risk of secondary haematological malignancies in patients with follicular lymphoma: an analysis of 1028 patients treated in the rituximab era
Corresponding Author
Roosa E. I. Prusila
Medical Research Centre and Cancer and Translational Research Unit, University of Oulu and Oulu University Hospital, Oulu, Finland
Correspondence: Roosa E. I. Prusila, Oulu University Hospital, Syöpätautien tutkimuslaboratorio, Kajaanintie 50, 90220 Oulu, Finland.
E-mail: [email protected]
Search for more papers by this authorMarc Sorigue
Department of Haematology, ICO-Hospital Germans Trias i Pujol, Institut de Recerca Josep Carreras, Badalona, Spain
Search for more papers by this authorJyrki Jauhiainen
Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
Search for more papers by this authorSantiago Mercadal
Department of Haematology, ICO-Hospital Duran i Reynals, Hospitalet de Llobregat, Barcelona, Spain
Search for more papers by this authorAleksi Postila
Medical Research Centre and Cancer and Translational Research Unit, University of Oulu and Oulu University Hospital, Oulu, Finland
Search for more papers by this authorPetteri Salmi
Medical Research Centre and Cancer and Translational Research Unit, University of Oulu and Oulu University Hospital, Oulu, Finland
Search for more papers by this authorTaru Tanhua
Medical Research Centre and Cancer and Translational Research Unit, University of Oulu and Oulu University Hospital, Oulu, Finland
Search for more papers by this authorSusanna Tikkanen
Medical Research Centre and Cancer and Translational Research Unit, University of Oulu and Oulu University Hospital, Oulu, Finland
Search for more papers by this authorSakari Kakko
Department of Haematology, Oulu University Hospital, Oulu, Finland
Search for more papers by this authorHanne Kuitunen
Medical Research Centre and Cancer and Translational Research Unit, University of Oulu and Oulu University Hospital, Oulu, Finland
Search for more papers by this authorMarjukka Pollari
Department of Oncology, Tampere University Hospital, Tampere, Finland
Search for more papers by this authorIlja Nystrand
Department of Oncology, Turku University Hospital, Turku, Finland
Search for more papers by this authorMilla E. L. Kuusisto
Medical Research Centre and Cancer and Translational Research Unit, University of Oulu and Oulu University Hospital, Oulu, Finland
Siunsote – Hospital District of North Carelia, Joensuu, Finland
Search for more papers by this authorKaija Vasala
Department of Oncology and Radiotherapy, Central Finland Central Hospital, Jyväskylä, Finland
Search for more papers by this authorEsa Jantunen
Siunsote – Hospital District of North Carelia, Joensuu, Finland
Department of Medicine, Kuopio University Hospital, Kuopio, Finland
Institute of Clinical Medicine, Faculty of Health Medicine, University of Eastern Finland, Kuopio, Finland
Search for more papers by this authorEija Korkeila
Department of Oncology, Turku University Hospital, Turku, Finland
Search for more papers by this authorPeeter Karihtala
Medical Research Centre and Cancer and Translational Research Unit, University of Oulu and Oulu University Hospital, Oulu, Finland
Search for more papers by this authorJuan-Manuel Sancho
Department of Haematology, ICO-Hospital Germans Trias i Pujol, Institut de Recerca Josep Carreras, Badalona, Spain
Search for more papers by this authorTaina Turpeenniemi-Hujanen
Medical Research Centre and Cancer and Translational Research Unit, University of Oulu and Oulu University Hospital, Oulu, Finland
Search for more papers by this authorOuti Kuittinen
Medical Research Centre and Cancer and Translational Research Unit, University of Oulu and Oulu University Hospital, Oulu, Finland
Institute of Clinical Medicine, Faculty of Health Medicine, University of Eastern Finland, Kuopio, Finland
Department of Oncology, Kuopio University Hospital, Kuopio, Finland
Search for more papers by this authorCorresponding Author
Roosa E. I. Prusila
Medical Research Centre and Cancer and Translational Research Unit, University of Oulu and Oulu University Hospital, Oulu, Finland
Correspondence: Roosa E. I. Prusila, Oulu University Hospital, Syöpätautien tutkimuslaboratorio, Kajaanintie 50, 90220 Oulu, Finland.
E-mail: [email protected]
Search for more papers by this authorMarc Sorigue
Department of Haematology, ICO-Hospital Germans Trias i Pujol, Institut de Recerca Josep Carreras, Badalona, Spain
Search for more papers by this authorJyrki Jauhiainen
Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
Search for more papers by this authorSantiago Mercadal
Department of Haematology, ICO-Hospital Duran i Reynals, Hospitalet de Llobregat, Barcelona, Spain
Search for more papers by this authorAleksi Postila
Medical Research Centre and Cancer and Translational Research Unit, University of Oulu and Oulu University Hospital, Oulu, Finland
Search for more papers by this authorPetteri Salmi
Medical Research Centre and Cancer and Translational Research Unit, University of Oulu and Oulu University Hospital, Oulu, Finland
Search for more papers by this authorTaru Tanhua
Medical Research Centre and Cancer and Translational Research Unit, University of Oulu and Oulu University Hospital, Oulu, Finland
Search for more papers by this authorSusanna Tikkanen
Medical Research Centre and Cancer and Translational Research Unit, University of Oulu and Oulu University Hospital, Oulu, Finland
Search for more papers by this authorSakari Kakko
Department of Haematology, Oulu University Hospital, Oulu, Finland
Search for more papers by this authorHanne Kuitunen
Medical Research Centre and Cancer and Translational Research Unit, University of Oulu and Oulu University Hospital, Oulu, Finland
Search for more papers by this authorMarjukka Pollari
Department of Oncology, Tampere University Hospital, Tampere, Finland
Search for more papers by this authorIlja Nystrand
Department of Oncology, Turku University Hospital, Turku, Finland
Search for more papers by this authorMilla E. L. Kuusisto
Medical Research Centre and Cancer and Translational Research Unit, University of Oulu and Oulu University Hospital, Oulu, Finland
Siunsote – Hospital District of North Carelia, Joensuu, Finland
Search for more papers by this authorKaija Vasala
Department of Oncology and Radiotherapy, Central Finland Central Hospital, Jyväskylä, Finland
Search for more papers by this authorEsa Jantunen
Siunsote – Hospital District of North Carelia, Joensuu, Finland
Department of Medicine, Kuopio University Hospital, Kuopio, Finland
Institute of Clinical Medicine, Faculty of Health Medicine, University of Eastern Finland, Kuopio, Finland
Search for more papers by this authorEija Korkeila
Department of Oncology, Turku University Hospital, Turku, Finland
Search for more papers by this authorPeeter Karihtala
Medical Research Centre and Cancer and Translational Research Unit, University of Oulu and Oulu University Hospital, Oulu, Finland
Search for more papers by this authorJuan-Manuel Sancho
Department of Haematology, ICO-Hospital Germans Trias i Pujol, Institut de Recerca Josep Carreras, Badalona, Spain
Search for more papers by this authorTaina Turpeenniemi-Hujanen
Medical Research Centre and Cancer and Translational Research Unit, University of Oulu and Oulu University Hospital, Oulu, Finland
Search for more papers by this authorOuti Kuittinen
Medical Research Centre and Cancer and Translational Research Unit, University of Oulu and Oulu University Hospital, Oulu, Finland
Institute of Clinical Medicine, Faculty of Health Medicine, University of Eastern Finland, Kuopio, Finland
Department of Oncology, Kuopio University Hospital, Kuopio, Finland
Search for more papers by this authorSummary
Follicular lymphoma (FL) is the most common indolent lymphoma. Currently there are many comparable treatment options available for FL. When selecting the most optimal therapy it is important to consider possible late effects of the treatment as well as survival. Secondary haematological malignancy (SHM) is a severe late effect of treatments, but the incidence of SHMs is still largely unknown. The goal of the present study was to determine the incidence of SHMs and how therapeutic decisions interfere with this risk. The study included 1028 FL patients with a median follow-up time of 5·6 years. The 5-year risk of SHM was 1·1% and the risk was associated with multiple lines of treatment (P = 0·016). The 5-year risk of SHM was 0·5% after the first-line treatment and 1·6% after the second-line. The standardized incidence ratio (SIR) was 6·2 (95% confidence interval 3·4–10·5) for SHM overall. This retrospective study found that the risk of SHM was low after first-line treatment in FL patients from the rituximab era. However, the risk of SHM increases with multiple lines of treatment. Therapeutic approaches should aim to achieve as long a remission as possible with first-line treatment, thereby postponing the added risk of SHM.
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