Second Hematologic Malignancies After Radioiodine Exposure In Patients With Thyroid Cancer and The Relationship With Radioiodine Dosage: A Nationwide Population-Based Study

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 1375-1375
Author(s):  
Chia-Jen Liu ◽  
Man-Hsin Hung ◽  
Chung-Jen Teng ◽  
Yu-Wen Hu ◽  
Yi-Ping Hung ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Dose Response ◽  
Hematologic Malignancies ◽  
Population Based ◽  
Second Primary ◽  
Population Based Study ◽  
Increased Risk ◽  
Clear Dose Response ◽  
Second Primary Malignancies

Abstract Background Second primary malignancies are one of the most important late effects after radioactive iodine (RAI) exposure, which is widely used in the diagnosis and treatment for thyroid cancers. However, dose-response correlation between RAI and second hematologic malignancies (SHM) was not established. Therefore, we conducted a nationwide population-based study to investigate the risk of SHM among thyroid cancer patients and the association between RAI dosage and development of SHM, including leukemia. Material and methods We recruited patients with newly diagnosed thyroid cancer aged 20 years or older without antecedent cancer from the Taiwan National Health Insurance database between 1997 and 2010. The standardized incidence ratios (SIR) of cancers were calculated to compare the cancer incidence of thyroid cancer patients to the general population according to gender, calendar year, and age in 5-year intervals by the corresponding stratum-specific person-time accrued in the cohort. The association of cumulative RAI dosage and development of SHM, including leukemia, was estimated using time-dependent analysis with 2-year latent period. Results After exclusion of first-year follow-up, 692 second primary malignancies developed among 20,235 patients with thyroid cancer, with a follow-up of 134,178 person-years. Fifty SHM developed with a SIR of 2.37 (95% confidence interval 1.76-3.13). The significant increased risk of SHM included: leukemia (SIR, 2.74; 95% CI, 1.65-4.28), non-Hodgkin lymphoma (SIR, 2.38; 95% CI, 1.55-3.48). As a time-dependent covariate with a 2-year latent period, RAI significantly increased the risk of leukemia with a clear dose-response correlation (age- and sex-adjusted hazard ratio per 100 mCi increase, 1.10; 95% CI, 1.01-1.19, P = 0.032). This effect was not seen in other second primary malignancies. Conclusions Our study reveals increased risk of SHM among patients with thyroid cancer. RAI increases the risk of leukemia with a clear dose-response relationship. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Second primary malignancies following thyroid cancer: a population-based study in Taiwan

2013 ◽  
Vol 169 (5) ◽  
pp. 577-585 ◽  
Author(s):  
Chang-Hsien Lu ◽  
Kuan-Der Lee ◽  
Ping-Tsung Chen ◽  
Chih-Cheng Chen ◽  
Feng-Che Kuan ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Large Scale ◽  
Negative Impact ◽  
Asian Population ◽  
Population Based ◽  
Second Primary ◽  
Population Based Study ◽  
Impact On Survival ◽  
Second Primary Malignancies

ObjectiveMost studies on second primary malignancies (SPMs) after primary thyroid cancer were conducted in USA or Europe. The discrepancy between SPMs in these studies could be attributed to geographical and ethnic heterogeneity. Thus, there is a clear need for another large-scale epidemiological study, particularly in Asian countries, to define the incidence and risk of SPMs in thyroid cancer survivors.DesignA population-based study was conducted using the nation-wide database from Taiwan Cancer Registry between 1979 and 2006.MethodsWe quantified standardized incidence ratios (SIRs) and cumulative incidence of SPMs among 19 068 individuals (4205 males and 14 863 females) with primary thyroid cancer.ResultsA total of 644 cases (3.38%) developed at least a SPM during 134 678 person-years of follow-up. The risk for subsequent SPMs was significantly greater than that of the general population (SIR=1.33, 95% CI 1.23–1.44). There was a greater risk of developing major salivary glands, nasopharyngeal, lung, thymus, breast (females), bladder, and brain cancers, and leukemia and lymphoma. We observed that the risk was highest within the first 5 years of diagnosis of thyroid cancer (SIR=5.29, 1.68, and 0.68 for ≦5, 5–10, and >10 respectively) and in the younger patients (SIR=1.81 vs 1.61 for <50 and ≧50 respectively). The median overall survival for primary thyroid cancer patients was 23.28 years, but it was only 4.73 years for those who developed SPMs.ConclusionThyroid cancer is associated with a 33% risk increment of SPMs, which had a negative impact on survival. There are sites of SPMs in the Asian population that are distinctive from those in the Western population, suggesting that other genetic predisposition or environmental factors may play a role.

Second primary malignancies in gastric cancer: A U.S. population-based study.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 191-191
Author(s):  
Binay Kumar Shah ◽  
Amit Khanal
Keyword(s):  
Breast Cancer ◽  
Prostate Cancer ◽  
Gastric Cancer ◽  
Thyroid Cancer ◽  
Myeloid Leukemia ◽  
Population Based ◽  
Second Primary ◽  
Population Based Study ◽  
Gastrointestinal Malignancies ◽  
Second Primary Malignancies

191 Background: Risk of second primary malignancies (SPM) is not known in gastric cancer. In this population based study, we analyzed rates of SPM in gastric cancer. Methods: We selected adult (≥18 years) patients with gastric cancer as first primary malignancy diagnosed from January 1992 to December 2011 from Surveillance, Epidemiology and End Result 13 database. We used SEER*stat’s multiple primary standardized incidence ratio (MP-SIR) session to calculate the risk of SPM diagnosed 6 months after the diagnosis of index gastric cancer. Results: Among 31,818 patients with first primary gastric cancer, 1674 (5.26%) developed 1,839 SPM with observed/expected (O/E) ratio of 1.09 (95% CI = 1.05-1.15, p<0.0001) and excess risk of 16.15 per 10,000 population. The median time to first SPM from the time of diagnosis of stomach cancer was 49 months (range 6 months to 19.08 years). There was significantly increased risk of gastrointestinal malignancies [O/E ratio 1.65 (CI=1.53-1.79, p<0.001)], thyroid cancer [O/E ratio 1.98 (CI=1.32-2.84, p<0.01)] and myeloid leukemia [O/E ratio 1.47(CI=1-2.09, p<0.05)]. Interestingly, there was significantly decreased risk of melanoma, breast cancer and prostate cancer. Conclusions: Our study showed that patients with gastric cancer are at higher risk of gastrointestinal malignancies, thyroid cancer and myeloid leukemia. Similarly, risk of melanoma, breast cancer and prostate cancer in patients with gastric cancer is lower than general population.

scholarly journals Spectrum of Second Primary Malignancies in Pediatric and Adult Langerhans Cell Histiocytosis Cases

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 51-52 ◽  
Author(s):  
Richa Parikh ◽  
Ronald S. Go ◽  
Gaurav Goyal
Keyword(s):  
General Population ◽  
Hodgkin Lymphoma ◽  
Solid Tumors ◽  
Adult Population ◽  
Hematologic Malignancies ◽  
Population Based ◽  
Second Primary ◽  
Non Hodgkin Lymphoma ◽  
Increased Risk ◽  
Second Primary Malignancies

Introduction: Langerhans cell histiocytosis (LCH) is a rare MAPK-ERK pathway driven histiocytic neoplasm that occurs in pediatric as well as adult population. Despite improvement in clinical outcomes, there is some data to suggest an increased propensity to develop second primary malignancies (SPMs) in LCH patients. However, population-based studies analyzing the incidence and spectrum of SPMs in pediatric and adult LCH patients are lacking. In this study, we utilized the Surveillance, Epidemiology and End Results (SEER) database to examine the various SPMs occurring among pediatric and adult LCH cases. Methods: We used the November 2018 submission of the SEER 18 registry, which covers ~27.8% of the US population based on the 2010 census, as our database. We used the SEER*Stat version 8.3.6 statistical software to analyze data. We identified cases diagnosed with LCH as their first primary malignancy between 2000 and 2016 using International Classification of Diseases for Oncology edition 3 (ICD-O-3) codes, including LCH NOS (not otherwise specified) (9751/1), LCH (9751/3), LCH, unifocal (9752/1), LCH, multifocal (9753/3), LCH, disseminated, borderline (9754/1) and Disseminated LCH (9754/3). These cases were followed for 180+months, and the standardized incidence ratio (SIR) or relative risk and absolute excess risk (AER) were calculated. We examined the differences in occurrence of SPMs among the pediatric (Age &lt;18 years) and adult population (Age ≥18 years). Additionally, we evaluated the concurrent and prior cancers in LCH patients as an exploratory objective. Results: The study included 1392 cases with LCH (Table 1), with median age at diagnosis 8 years (range newborn - 86 years). Out of these cases, 1205 (87%) were diagnosed as LCH and 186 (13%) as disseminated LCH. 936 cases (67%) were diagnosed at age &lt;18 years (pediatric LCH), while 456 cases (33%) were diagnosed at age ≥18 years (adult LCH). The overall age-adjusted incidence rate for LCH was found to be 1 per 1,000,000. The incidence rate was 2.6 per 1,000,000 in pediatric LCH group and 0.4 per 1,000,000 in the adult LCH group. Out of the entire cohort, 20 (1.4%) cases developed a total of 21 SPMs [SIR 2.07; 95% Confidence Interval (CI): 1.28-3.16]. Median latency period to development of SPMs was 28 months. The pediatric LCH group had an overall higher risk of developing SPMs [SIR 6.42, 95%CI 2.08-14.97] than the general population, especially for hematologic malignancies [SIR 18.76, 95%CI 6.09-43.78], mainly, nodal Hodgkin lymphoma [SIR 60.93, 95%CI 7.38-220.12] and extranodal non-Hodgkin lymphoma [SIR 60.88, 95%CI 1.54-339.2]. No solid tumors were seen in this group. The adult LCH group did not have an overall increased risk of developing SPMs than the general population [SIR 1.71, 95%CI 0.98-2.77], except for Acute Lymphocytic Leukemia (ALL) [SIR 66.29, 95%CI 1.68-369.36] especially 60-119 months from diagnosis of LCH and miscellaneous cancers [SIR 11.43, 95%CI 2.36-33.39] especially 12-59 months after diagnosis of LCH. 62.5% of SPMs that developed in the adult LCH group were solid tumors, however, the overall risk for developing solid tumors was not higher than the general population [SIR 1.2, 95%CI 0.58-2.2], except for carcinoma in-situ of vulva [SIR 62.72, 95%CI 1.59-349.45] 2-11 months from diagnosis of LCH. Overall, tumors of the respiratory system (21%), female breast (13%) and prostate (9%) were the most common malignancies occurring prior to development of LCH whereas tumors of the respiratory system (28%), non-Hodgkin lymphoma (20%) and endocrine system (13%) occurred concurrent to LCH. Conclusion: To our knowledge, this is the first comprehensive population-based study assessing the incidence of SPMs in pediatric and adult LCH. Our study shows that the incidence of LCH is higher in the pediatric age group compared to adults. We found an increased risk for hematologic malignancies, specifically for Hodgkin and non-Hodgkin lymphoma in pediatric LCH compared to the general population. Among adult LCH, however, the risk was higher for development of ALL and carcinoma in-situ of vulva when compared to the general population. Our results may help guide survivorship and surveillance strategies among LCH patients. More studies are needed to understand the molecular underpinning leading to increased SPM formation in LCH patients. Disclosures No relevant conflicts of interest to declare.

scholarly journals The Risk of Second Primary Malignancies up to Three Decades after the Treatment of Differentiated Thyroid Cancer

2008 ◽  
Vol 93 (2) ◽  
pp. 504-515 ◽  
Author(s):  
Aaron. P. Brown ◽  
Jergin Chen ◽  
Ying J. Hitchcock ◽  
Aniko Szabo ◽  
Dennis C. Shrieve ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
General Population ◽  
Differentiated Thyroid Cancer ◽  
Second Primary ◽  
Second Primary Cancers ◽  
Increased Risk ◽  
Absolute Excess Risk ◽  
Second Primary Malignancies ◽  
Radioisotope Therapy

Abstract Background: The 10-yr survival rate of patients with differentiated thyroid cancer exceeds 90%. These patients may be at elevated risk for secondary cancers. Methods: The risk of nonthyroid second primary malignancies after differentiated thyroid cancer was determined in 30,278 patients diagnosed between 1973 and 2002 from centers participating in the National Cancer Institute’s Surveillance, Epidemiology, and End Results program. Median follow-up was 103 months (range, 2–359 months). Risk was further assessed for the addition of radioisotope therapy, gender, latency to development of secondary cancer, and age at thyroid cancer diagnosis. Results: There were 2158 patients who developed a total of 2338 nonthyroid second primary malignancies, significantly more than that expected in the general population [observed/expected (O/E) = 1.09; 95% confidence interval (CI), 1.05–1.14; P &lt; 0.05; absolute excess risk per 10,000 person-years (AER) = 6.39]. A significantly greater risk of second primary malignancies over that expected in the general population was for patients treated with radioisotopes (O/E = 1.20; 95% CI, 1.07–1.33; AER = 11.8) as well as for unirradiated patients (O/E = 1.05; 95% CI, 1.00–1.10; AER = 3.53). However, the increased risk was greater for the irradiated vs. the unirradiated cohort (relative risk = 1.16; 95% CI, 1.05–1.27; P &lt; 0.05). Gender did not affect risk. The greatest risk of second primary cancers occurred within 5 yr of diagnosis and was elevated for younger patients. Conclusions: The overall risk of second primary malignancies is increased for thyroid cancer survivors and varies by radioisotope therapy, latency, and age at diagnosis.

scholarly journals Risk of Second Primary Malignancies in Chronic Lymphocytic Leukemia

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 3581-3581 ◽  
Author(s):  
Anuhya Kommalapati ◽  
Sri Harsha Tella ◽  
Gaurav Goyal
Keyword(s):  
Prostate Cancer ◽  
Lung Cancer ◽  
Thyroid Cancer ◽  
Myeloid Leukemia ◽  
Population Based ◽  
Elevated Risk ◽  
Lymphocytic Leukemia ◽  
Second Primary ◽  
Second Primary Malignancies

Abstract Introduction: Chronic lymphocytic leukemia (CLL) is the most common type of adult leukemia, with ~21,000 estimated new cases in 2018. Prior retrospective studies have suggested an increased risk of second primary malignancies (SPMs) in CLL patients. Population-based studies on the risk of SPMs in CLL are limited, especially in the last decade with improvements in prognostic and therapeutic tools over the last decade. As the survival of CLL patient improves, it may lead to more survivors who are at risk of developing SPMs. In this study, we sought to evaluate the risk of development of SPMs among CLL patients diagnosed from 2000-2014. Methods: We used the SEER 18 registries for the calculation of risk of SPMs and included CLL cases that were confirmed histologically between 2000-2014 (https://seer.cancer.gov/). SPMs diagnosed within 2 months of primary CLL diagnosis were excluded. Time to SPM was calculated by subtracting second malignancy survival/follow-up time from CLL survival/follow-up time. The SEER*Stat Multiple Primary-SIR tool was used to calculate SIRs for secondary malignancies by comparing these patients' subsequent cancer experience with the number of cancers that would be expected based on incidence rates for the general U.S. population. These analyses were adjusted for age, gender, race, and year of CLL diagnosis. Multivariate logistic regression was performed to identify factors associated with development of SPM. Results: The study cohort included 46,164 patients with CLL. After a median follow up of 50 months (range 1-179), 5220 (11.3%) patients developed a total of 5,738 subsequent malignancies. As compared to that of general population, CLL patients had a higher risk of developing SPMs (SIR: 1.40 [95%CI:1.37-1.44]) and the risk was much higher for hematologic malignancies (SIR: 2.63 [95%CI:2.47-2.80]) as compared to solid organ malignancies (SIR: 1.25 [95%CI: 1.22-1.29]). In addition to known common SPMs in CLL (lymphoma, melanoma, lung cancer, and prostate cancer), there was an elevated risk of developing acute lymphoblastic leukemia (SIR 5.43), chronic myeloid leukemia (SIR 2.18), thyroid cancer (SIR 2.09), and kidney cancer (SIR 1.70) (Table). Out of the 5220 patients who developed SPMs, 437 (8.3%) patients developed two subsequent second primary malignancies, and 81 (1.5%) patients developed > 2 subsequent primary cancers, which was significantly more than the endemic rate (SIR, 1.40; p <.05). Of the 5738 SPMs, 1095 (19%) occurred in 2-11 months, 2822 (49%) in 1-5 years, 1499 (26%) in 6-10 years and 321 (6%) beyond 10 years of CLL diagnosis (Figure). On logistic regression, males had higher odds of developing SPMs than females (OR: 1.46 [95% CI: 1.38-1.56], p<0.0001) and the patients diagnosed with from 2000-2007 had higher odds of developing SPMs as compared to those diagnosed from 2007-2014 (OR: 2.28 [95%CI: 2.15-2.42], p<0.0001]. The risk of developing SPM did not differ based on the age, race and between the patients who received first line therapy and no initial therapy. CLL patients who developed SPMs had significantly less median overall survival as compared to that of patients who did not develop SPMs (93 vs 109 months, p<0.05). Conclusion: In this large population-based study, CLL patients had an elevated risk of developing second primary hematologic and solid malignancies. The specific types of SPMs were varied, ranging from common ones such as lymphoma, lung cancer, prostate cancer, to uncommon ones such as thyroid cancer, kidney cancer, and chronic myeloid leukemia. The patients who were diagnosed after 2007 had a lower risk of developing SPMs as compared to those diagnosed before. There is a need for studies evaluating immunological repertoire of CLL and its impact on development of SPMs. Knowledge of these SPMs may help physicians with their early detection. Disclosures No relevant conflicts of interest to declare.

scholarly journals Dietary and lifestyle inflammatory scores are associated with increased risk of metabolic syndrome in Iranian adults

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Hossein Farhadnejad ◽  
Karim Parastouei ◽  
Hosein Rostami ◽  
Parvin Mirmiran ◽  
Fereidoun Azizi
Keyword(s):  
Metabolic Syndrome ◽  
Positive Association ◽  
Population Based ◽  
Population Based Study ◽  
Logistic Regression Models ◽  
Increased Risk ◽  
Confounding Variables ◽  
Adjusted Model ◽  
Diet And Lifestyle

Abstract Background In the current study, we aimed to investigate the association of dietary inflammation scores (DIS) and lifestyle inflammation scores (LIS) with the risk of metabolic syndrome (MetS) in a prospective population-based study. Methods A total of 1625 participants without MetS were recruited from among participants of the Tehran Lipid and Glucose Study(2006–2008) and followed a mean of 6.1 years. Dietary data of subjects were collected using a food frequency questionnaire at baseline to determine LIS and DIS. Multivariable logistic regression models, were used to calculate the odds ratio (ORs) and 95 % confidence interval (CI) of MetS across tertiles of DIS and LIS. Results Mean ± SD age of individuals (45.8 % men) was 37.5 ± 13.4 years. Median (25–75 interquartile range) DIS and LIS for all participants was 0.80 (− 2.94, 3.64) and 0.48 (− 0.18, − 0.89), respectively. During the study follow-up, 291 (17.9 %) new cases of MetS were identified. Based on the age and sex-adjusted model, a positive association was found between LIS (OR = 7.56; 95% CI 5.10–11.22, P for trend < 0.001) and risk of MetS, however, the association of DIS and risk of MetS development was not statistically significant (OR = 1.30;95% CI 0.93–1.80, P for trend = 0.127). In the multivariable model, after adjustment for confounding variables, including age, sex, body mass index, physical activity, smoking, and energy intake, the risk of MetS is increased across tertiles of DIS (OR = 1.59; 95% CI 1.09–2.33, P for trend = 0.015) and LIS(OR = 8.38; 95% CI 5.51–12.7, P for trend < 0.001). Conclusions The findings of the current study showed that greater adherence to LIS and DIS, determined to indicate the inflammatory potential of diet and lifestyle, are associated with increased the risk of MetS.

scholarly journals Risk of second primary malignancies in patients with follicular lymphoma: a population-based study in the Netherlands, 1989-2018

2021 ◽  
Vol 11 (11) ◽  
Author(s):  
Manette A. W. Dinnessen ◽  
Otto Visser ◽  
Sanne H. Tonino ◽  
Eduardus F. M. Posthuma ◽  
Nicole M. A. Blijlevens ◽  
...  
Keyword(s):  
The Netherlands ◽  
Follicular Lymphoma ◽  
Population Based ◽  
Second Primary ◽  
Population Based Study ◽  
Second Primary Malignancies

Abstract 1158: Sudden Death in Children with Cardiomyopathy: Long Term Follow-Up from a National Population-Based Study of Childhood Cardiomyopathy

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Tara Bharucha ◽  
Andrew M Davis ◽  
Christian Turner ◽  
Robert Justo ◽  
Terry Robertson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Primary Prevention ◽  
Sudden Death ◽  
Systolic Dysfunction ◽  
Population Based ◽  
Z Score ◽  
Icd Implantation ◽  
Population Based Study ◽  
Increased Risk

Introduction Better data regarding the incidence and risk factors for sudden cardiac death (SCD) in children with cardiomyopathy (CM) is critical in defining appropriate primary prevention strategies. Methods The National Australian Childhood Cardiomyopathy Study is a prospective cohort study, including all children in Australia with primary CM diagnosed at 0 – 10 years of age, between 1987–1997. SCD was defined as sudden and unexpected death in children who were not hospitalized and not in congestive heart failure at the time of death. Nine subjects with sudden death as presenting symptom were excluded. Indexed echocardiographic measurements at latest follow-up were compared between subjects with SCD and survivors. Results Study criteria were met by 291 children. Mean duration of follow-up was 9.2 years. The incidence of sudden death relative to each CM type, for all cases and as a proportion of deaths, is shown in the Table : Incidence of SCD by CM type. SCD incidence was significantly associated with CM type, for all cases ( p = 0.006) and when only those subjects who died were considered ( p = 0.005), with LVNC and RCM having up to 4 times the risk of other CM types. Children with familial DCM had a significantly higher rate of SCD than subjects with non-familial CM (12% vs 3%; p = 0.028), however, familial CM was not a risk factor in other CM types. DCM SCD subjects had larger LVEDd Z score than survivors (median 5.53 vs 1.16; p <0.0001) and lower FS Z score (median −9.23 vs −0.51; p = 0.0025). HCM SCD subjects had thicker LVPW dimension Z scores than survivors (median 4.63 vs 1.18; p = 0.007). Twelve subjects (2 DCM, 8 HCM and 2 LVNC) underwent ICD implantation (8/12 for primary prevention). Conclusions: This population based study defines new risk factors for sudden death in children with CM. RCM is well known to have a high incidence of SCD. In addition, children with LVNC and those with DCM who have severe dilatation, systolic dysfunction or familial DCM are at increased risk of sudden death.

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