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. 2017 Jun;6(6):1233-1239.
doi: 10.1002/cam4.1081. Epub 2017 May 23.

Role of treatment on the development of secondary malignancies in patients with essential thrombocythemia

Cristina Santoro  1 , Isabella Sperduti  2 , Roberto Latagliata  1 , Erminia Baldacci  1 , Barbara Anaclerico  3 , Giuseppe Avvisati  4 , Massimo Breccia  1 , Francesco Buccisano  5 , Michele Cedrone  3 , Giuseppe Cimino  6 , Cinzia De Gregoris  7 , Marianna De Muro  4 , Ambra Di Veroli  5 , Sabrina Leonetti Crescenzi  8 , Marco Montanaro  7 , Enrico Montefusco  9 , Raffaele Porrini  9 , Angela Rago  6 , Antonio Spadea  10 , Francesca Spirito  11 , Nicoletta Villivà  12 , Alesssandro Andriani  12 , Giuliana Alimena  1 , Maria Gabriella Mazzucconi  1
Affiliations

Role of treatment on the development of secondary malignancies in patients with essential thrombocythemia

Cristina Santoro et al. Cancer Med. 2017 Jun.

Abstract

Aim of this study is to explore the role of different treatments on the development of secondary malignancies (SMs) in a large cohort of essential thrombocythemia (ET) patients. We report the experience of a regional cooperative group in a real-life cohort of 1026 patients with ET. We divided our population into five different groups: group 0, no treatment; group 1, hydroxyurea (HU); group 2, alkylating agents (ALK); group 3, ALK + HU sequentially or in combination; and group 4, anagrelide (ANA) and/or α-interferon (IFN) only. Patients from groups 1, 2, and 3 could also have been treated either with ANA and/or IFN in their medical history, considering these drugs not to have an additional cytotoxic potential. In all, 63 of the 1026 patients (6%) developed 64 SM during the follow-up, after a median time of 50 months (range: 2-158) from diagnosis. In univariate analysis, a statistically significant difference was found only for gender (P = 0.035) and age (P = 0.0001). In multivariate analysis, a statistically significant difference was maintained for both gender and age (gender HR1.7 [CI 95% 1.037-2.818] P = 0.035; age HR 4.190 [CI 95% 2.308-7.607] P = 0.0001). The impact of different treatments on SMs development was not statistically significant. In our series of 1026 ET patients, diagnosed and followed during a 30-year period, the different therapies administered, comprising HU and ALK, do not appear to have impacted on the development of SM. A similar rate of SMs was observed also in untreated patients. The only two variables which showed a statistical significance were male gender and age >60 years.

Keywords: Alkylating agents; alpha-interferon; anagrelide; essential thrombocythemia; hydroxyurea; secondary malignancy.

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Figures

Figure 1
Figure 1
Follow‐up and exposure time in the different therapy groups.
Figure 2
Figure 2
Kaplan–Mayer curve for secondary malignancy as regard as age.
Figure 3
Figure 3
Kaplan–Mayer curve for secondary malignancy as regard as sex.
See this image and copyright information in PMC

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