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Annals of Hematology

, Volume 98, Issue 10, pp 2367–2377 | Cite as

Characteristics, combinations, treatments, and survival of second primary hematological neoplasm: a retrospective single-center cohort of 49 patients (Hemo2study)

  • Thomas Chalopin
  • Nicolas Vallet
  • Flavie Arbion
  • Carole Barin
  • Emmanuelle Rault
  • Alban Villate
  • Martin Eloit
  • Laurianne Drieu La Rochelle
  • Amélie Foucault
  • Marjan Ertault
  • Caroline Dartigeas
  • Lotfi Benboubker
  • Marie-Hélène Estienne
  • Jorge Domenech
  • Olivier Hérault
  • Emmanuel GyanEmail author
Original Article

Abstract

The coexistence of dual hematological neoplasms is very rare. Sequential or synchronous neoplasms in hematology are an uncommon and complex clinical situation. The aim of the Hemo2 study was to describe the clinical characteristics and analyze the outcome of these patients. We performed a retrospective review of all patients diagnosed with sequential or synchronous hematological malignancies in the university hospital of Tours, between 2007 and 2018. We identified 49 patients in our study, with a prevalence of 0.89%. Sequential and synchronous combinations were found in 36 (73%) and 13 (27%) patients, respectively. One patient presented three sequential neoplasms. The median cumulative incidence was 6 years (95% CI 3–7). Among all neoplasms diagnosed (n = 99), we found 79 lymphoid neoplasms (LNs) (80%) and 20 myeloid neoplasms (MNs) (20%). Sex ratio was 1.88 with 65% of males and 35% of females. The most common LNs were Hodgkin lymphoma (n = 16; 16%) and multiple myeloma (n = 11; 11%). The most frequent MN was essential thrombocythemia (n = 5; 5%). The most common combination was Hodgkin lymphoma and follicular lymphoma in five (10%) patients. The overall survival from the first diagnosis (OS1) at 5 years was 82.4% (95% CI 72.1–94.3). The median overall survival from the second diagnosis (OS2) was 98 months (95% CI 44–NR) and 5-year OS2 was 58.7% (95% CI 45.5–75.7). Median progression-free survival from the second diagnosis (PFS) was 47 months (95% CI 27–NR) with 5-year PFS of 49% (95% CI 35.9–67). OS and PFS did not statistically differ between synchronous and sequential dual neoplasms. In this cohort, that the death relative risk (RR) was significantly lower if the second neoplasm appeared after more than 4 years following the first diagnosis (OR 0.37 (95% CI 0.16–0.90)). The Hemo2study confirmed the rarity of dual hematological neoplasms. In this cohort, HL and FL were the most frequent combinations. Our results may support that synchronous and sequential dual neoplasms bear the same prognosis. Further studies are needed to better characterize these uncommon clinical situations.

Keywords

Lymphoid Myeloid Sequential Synchronous Hematological neoplasm 

Notes

Authors’ contributions

TC, NV, and EG collected, analyzed, and interpreted data, and wrote the manuscript. NV performed statistical analysis. FA, CB, ER, AV, ME, LDR, AF, ME, CD, LB, MHE, JD, and OH contributed essential tools and revised and approved the manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the ethical committee in human research of the Hospital of Tours (project Hemo2 Study no. 2018-108).

Supplementary material

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Thomas Chalopin
    • 1
  • Nicolas Vallet
    • 1
  • Flavie Arbion
    • 2
  • Carole Barin
    • 3
  • Emmanuelle Rault
    • 4
  • Alban Villate
    • 1
  • Martin Eloit
    • 1
  • Laurianne Drieu La Rochelle
    • 1
  • Amélie Foucault
    • 4
  • Marjan Ertault
    • 1
  • Caroline Dartigeas
    • 1
  • Lotfi Benboubker
    • 1
  • Marie-Hélène Estienne
    • 4
  • Jorge Domenech
    • 4
    • 5
  • Olivier Hérault
    • 4
    • 5
  • Emmanuel Gyan
    • 1
    • 5
    • 6
    Email author
  1. 1.Department of Hematology and Cell TherapyUniversity Hospital of ToursTours Cedex 9France
  2. 2.Department of PathologyUniversity Hospital of ToursToursFrance
  3. 3.Department of CytogeneticsUniversity Hospital of ToursToursFrance
  4. 4.Department of Biological HematologyUniversity Hospital of ToursToursFrance
  5. 5.University of ToursToursFrance
  6. 6.Clinical Investigation CenterUniversity Hospital of ToursToursFrance

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