Anthracyclines, Mitoxantrone, Radiotherapy, and Granulocyte Colony-Stimulating Factor: Risk Factors for Leukemia and Myelodysplastic Syndrome After Breast Cancer

2007 ◽  
Vol 25 (3) ◽  
pp. 292-300 ◽  
Author(s):  
Marie-Cécile Le Deley ◽  
Florence Suzan ◽  
Bruno Cutuli ◽  
Suzette Delaloge ◽  
Akthar Shamsaldin ◽  
...  

Purpose To determine the risk factors for acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS) after breast cancer. Patients and Methods We conducted a case-control study among women treated for breast cancer between 1985 and 2001 in French general hospitals, cancer centers, or clinics. We included 182 AML and MDS patients and 534 matched controls. Breast cancer characteristics, type of treatment, and family history of cancer were compared in both groups. Results The risk of AML/MDS was increased after topoisomerase-II inhibitor–based chemotherapy (P < 10−16) and was higher for mitoxantrone-based chemotherapy than for anthracycline-based chemotherapy (relative risk [RR] = 15.6; 95% CI, 7.1 to 34.2; and RR = 2.7; 95% CI, 1.7 to 4.5, respectively). After adjustment for other treatment components, the risk of AML/MDS in patients who received radiotherapy was multiplied by 3.9 (95% CI, 1.4 to 10.8) but was not increased by alkylating agents. Patients receiving granulocyte colony-stimulating factor (G-CSF) support had an increased risk of AML/MDS (RR = 6.3; 95% CI, 1.9 to 21), even when controlling for chemotherapy doses. Similar results were obtained when AML and MDS were considered separately. Conclusion This large case-control study demonstrates that the risk of AML/MDS is much higher with mitoxantrone-based chemotherapy than with anthracyclines-based chemotherapy in a population of women recently treated for breast cancer. The risk of AML/MDS associated with mitoxantrone must be kept in mind when using this drug to treat diseases other than breast cancer (eg, prostate cancer or multiple sclerosis). In addition, our study suggests the need to monitor the long-term effects of G-CSF therapy.

2020 ◽  
Author(s):  
Milad Pezeshki ◽  
Jamshid Ansari ◽  
Jafar Rezaie ◽  
Mojtaba Ahmadloo

Abstract BackgroundBreast cancer is the most common malignant in women globally. In Iran, breast cancer incidence rate is continuously increasing. This study aimed to investigate the risk factors for breast cancer in Iranian women.MethodsA hospital-based case-control study was conducted between September 2016 and July 2019 in Arak, Iran. The sample size was 400 breast cancer patients and 400 healthy women. Demographical records and risk factor related data were collected. Logistic regression analysis used to calculate odds ratios (ORs) and 95% confidence intervals (CIs).ResultsData showed that among various factors, urban life (OR = 1.361, 95% CI 1.025–1.808, P = 0.033), height (OR = 3.347, 95% CI 2.0443–5.480, P = 0.000), BMI (OR = 0.397, 95% CI 0.273–0.577, P = 0.000), education level (OR = 7.048, 95% CI 3.985–12.467, P = 0.000), awareness level (OR = 0.507, 95% CI 0.349–0.736, P = 0.000), job status (OR = 0.321, 95% CI 0.122–0.846, P = 0.022), economic status (OR = 4.333, 95% CI 1.424–13.184, P = 0.010), early menarche (OR = 2.815, 95% CI 1.745–4.541, P = 0.000), Stillbirth status (OR = 1.935, 95% CI 1.087–3.446, P = 0.025), family history (OR = 10.281, 95% CI 3.628–29.134, P = 0.000), behavioral habits (OR = 0.554, 95% CI 0.386–0.796, P = 0.001), and second-hand smoking (OR = 1.472, 95% CI 1.108–1.955, P = 0.008) significantly were associated with an increased risk for breast cancer.ConclusionThe data suggest that lifestyle may have more impact on the incidence of breast cancer in Iranian women, suggesting change unhealthy lifestyle and screening for preventing breast cancer.


2020 ◽  
Vol 42 (1) ◽  
pp. 79
Author(s):  
Asmita Rana ◽  
Anup Ghimire ◽  
Ram B Sah ◽  
Prajjwal Pyakurel ◽  
Nirmal P Shah

Introduction Breast cancer is the leading cause of cancer death among females worldwide. Its incidence is on the rise in Nepal. However, the risk factors have not been studied in context of Nepal. The aim of this study is to identify and quantify the association of various risk factors with breast cancer in Nepal. MethodsHospital-based age-matched case-control study was conducted among 50 cases and 150 controls visiting BP Koirala Memorial Cancer Hospital, Bharatpur, Nepal. Semi-structured questionnaire was used to collect information on demographic characters, socio-economic parameters, reproductive history, dietary and personal habits, family history, history of contraception and history of benign breast disease. Height, weight, hip circumference and waist circumference were measured. ResultsMajority of the cases (52%) belonged to the age group of 46-55 years. The significant risk factors were ethnicity of Dalit/Madhesi (AOR 8.222, 95% CI 2.377-28.441, p-value 0.001), parity of 3 to 5 (AOR 5.614, 95% CI 1.140-27.639, p-value 0.03) and previous history of benign breast disease (OR 13.614, 95% CI 3.229-57.391, p-value 0.001). Hysterectomy was found to reduce the risk of breast cancer (OR 0.122, 95% CI 0.017-0.826, p-value 0.03). Knowledge of breast self-examination was significantly higher among cases than controls (AOR 36.29, 95% CI 5.788-227.555, p-value < 0.001). Knowledge of mammography was significantly lower among cases than control (AOR=0.133, 95% CI=0.028-0.647, p-value=0.01). ConclusionThis study showed a number of factors to be associated with the increased risk of breast cancer. It was observed that the mean age at diagnosis is a decade earlier than in Western countries. Genetic component was not significant in context of Nepal. It is hoped that the findings of this study will facilitate further exploration and evidenced-based preventive measures for Nepalese women.


2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
S Singh ◽  
S Gupta ◽  
T S Mishra ◽  
B D Banerjee ◽  
T Sharma ◽  
...  

Abstract Introduction Nephrolithiasis is pathological calcification in the excretory passages of the body and is prevalent among 7.6% of Indians. We aimed to study the various risk factors associated with renal stones from India. Method It was a hospital-based case-control study conducted over 18 months in a tertiary hospital in Delhi. Cases were defined as patients with renal stones diagnosed on the basis of history and radiological examination. Controls were similar to cases in all respects except for the diagnosis and selected from the hospital. A total of 18 risk factors, including age, gender, heavy metals, stress, metabolic factors, alcohol intake, dietary habits, co-morbidities, etc. were assessed. Logistic regression analysis was performed to calculate the strength of the risk associations. Results In the analysis of 60 cases and controls, we found 6 times, 5.5 times, and 2.4 times increased odds of renal stones in patients with increased arsenic, cadmium, and lead concentrations in blood, respectively. Similarly, there are 3 times increased odds of renal stones in patients suffering from stress. Conclusions Exposure to smoke, occupation dust, and contaminated water may lead to an increased ingestion/inhalation of heavy metals like cadmium, arsenic, and predisposing people to an increased risk of renal stones.


2016 ◽  
Vol 27 ◽  
pp. ix24
Author(s):  
N.A. Jadoon ◽  
M. Hussain ◽  
F.U. Sulehri ◽  
A. Zafar ◽  
A. Ijaz

2020 ◽  
Vol 22 (1) ◽  
pp. 6-14
Author(s):  
Matthew I Hardman ◽  
◽  
S Chandralekha Kruthiventi ◽  
Michelle R Schmugge ◽  
Alexandre N Cavalcante ◽  
...  

OBJECTIVE: To determine patient and perioperative characteristics associated with unexpected postoperative clinical deterioration as determined for the need of a postoperative emergency response team (ERT) activation. DESIGN: Retrospective case–control study. SETTING: Tertiary academic hospital. PARTICIPANTS: Patients who underwent general anaesthesia discharged to regular wards between 1 January 2013 and 31 December 2015 and required ERT activation within 48 postoperative hours. Controls were matched based on age, sex and procedure. MAIN OUTCOME MEASURES: Baseline patient and perioperative characteristics were abstracted to develop a multiple logistic regression model to assess for potential associations for increased risk for postoperative ERT. RESULTS: Among 105 345 patients, 797 had ERT calls, with a rate of 7.6 (95% CI, 7.1–8.1) calls per 1000 anaesthetics (0.76%). Multiple logistic regression analysis showed the following risk factors for postoperative ERT: cardiovascular disease (odds ratio [OR], 1.61; 95% CI, 1.18–2.18), neurological disease (OR, 1.57; 95% CI, 1.11–2.22), preoperative gabapentin (OR, 1.60; 95% CI, 1.17–2.20), longer surgical duration (OR, 1.06; 95% CI, 1.02–1.11, per 30 min), emergency procedure (OR, 1.54; 95% CI, 1.09–2.18), and intraoperative use of colloids (OR, 1.50; 95% CI, 1.17–1.92). Compared with control participants, ERT patients had a longer hospital stay, a higher rate of admissions to critical care (55.5%), increased postoperative complications, and a higher 30-day mortality rate (OR, 3.36; 95% CI, 1.73–6.54). CONCLUSION: We identified several patient and procedural characteristics associated with increased likelihood of postoperative ERT activation. ERT intervention is a marker for increased rates of postoperative complications and death.


2002 ◽  
Vol 32 (3) ◽  
pp. 459-470
Author(s):  
Fayek El Khwsky ◽  
Amal El Sodafy ◽  
Mohammed Saleem ◽  
Dalal El-Guiziry

2018 ◽  
Vol 19 (1) ◽  
pp. 56-60 ◽  
Author(s):  
Shih-Chang Hung ◽  
Kuan-Fu Liao ◽  
Hung-Chang Hung ◽  
Cheng-Li Lin ◽  
Po-Chang Lee ◽  
...  

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