Incidence of second malignancies in patients with chronic myeloid leukemia in the era of tyrosine kinase inhibitors
Patients with chronic myeloid leukemia (CML) treated with tyrosine kinase inhibitors (TKIs) have near-normal life expectancies. With this comes the possibility of developing second cancers; we aimed to evaluate the incidence of second malignancies in patients with CML using Surveillance, Epidemiology, and End Results Program data. We identified 13,276 patients with CML newly diagnosed in 2001–2014. Patients who had prior history of cancer, a concurrent diagnosis of other malignancies in the same diagnostic year, or a second leukemia after CML diagnosis were excluded. Second malignancies were observed in 597 patients (4%) with a median follow-up of 69 months. The 5- and 10-year cumulative incidences of death for all patients were 30.5% and 41.8%. The 5- and 10-year cumulative incidences of second malignancies were 4.4% and 7.2%, respectively. The overall standardized incidence ratio (SIR) was 1.204. Increased SIRs compared to the general population were observed for the male genital system, 1.593; digestive system, 1.291; skin, 1.588; and urinary system, 1.366. Overall excess absolute risk was 1.714 per 1000 person-years at risk. Our results suggest that relative incidence of overall second malignancies in CML is slightly higher than that of the general population, with minimal increase in the excess absolute risk.
KeywordsChronic myeloid leukemia Tyrosine kinase inhibitor Second malignancies
This study was partly supported by the National Institutes of Health/National Cancer Institute under Award Number P30 CA016672 and Award Number P01 CA049639. We also acknowledge the Department of Scientific Publications for editorial assistance.
KS collected data, designed the study, analyzed the data and wrote the manuscript. HMK, SO’B, FR, MK, GB, GGM, WGW, ND, AF, KT, PJ, MBR, SAP, and EJJ edited the manuscript. JEC designed the study, analyzed the data, and edited the manuscript. All authors provided significant intellectual input and reviewed and approved the final version of the manuscript.
Compliance with ethical standards
Conflict of interest
HMK received research grants from Novartis, Bristol-Myers Squibb, Pfizer, and Ariad. FR received research funding from Novartis and Bristol-Myers Squibb. EJJ received consultancy fees from Ariad, Bristol-Myers Squibb, Teva, and Pfizer. JEC received research support from Ariad, Bristol-Myers Squibb, Novartis, Pfizer, and Teva and is a consultant for Ariad, Bristol-Myers Squibb, Novartis, and Pfizer. KS, SO’B, MK, GB, GGM, WGW, ND, AF, KT, PJ, MBR, and SAP declare that they have no relevant conflict of interest.
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