Second primary cancers in young adult colorectal cancer survivors.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 516-516 ◽  
Author(s):  
Raji Shameem ◽  
Muhammad Saad Hamid ◽  
James Luke Godwin ◽  
Niket Sonpal ◽  
Kevin M. Sullivan
Keyword(s):  
Young Adult ◽  
Solid Tumors ◽  
Hematological Malignancies ◽  
Latency Period ◽  
Initial Diagnosis ◽  
Second Primary ◽  
Second Cancer ◽  
Second Primary Cancers ◽  
Increased Risk ◽  
Female Genital

516 Background: Second primary cancers are a major concern for young adult colorectal cancer (CRC) survivors. The impact of treatment with radiation on the risk for second solid and hematological malignancies, as well as the typical latency period before development of a second cancer, requires elucidation. Methods: The Surveillance Epidemiology and End Results (SEER) database was used to detect CRC cases in young adults (aged 20-40 years) diagnosed up to 12/31/2011. The Standardized Incidence Ratio (SIR) was calculated as the ratio of observed to expected cases of second primary malignancy based on incidence data in the general United States population. The latency exclusion period from the date of diagnosis was 5 years. We investigated the possible effect of radiation therapy on risk for a second cancer, and established the typical latency period after initial diagnosis (5-10 years and >10 years). Results: A total of 9,537 cases of CRC in young adults were available for analysis. Radiation was administered in 1,823 (19.1%) patients. Second primary cancers occurred in 798 cases, 754 (94.5%) solid tumors and 44 (5.5%) hematological malignancies respectively. In the latency period 5-10 years after initial diagnosis, “All Solid Tumors” (SIR: 1.85, p<0.05) and female genital tumors (SIR: 3.52, p<0.05) were increased. In the latency period >10 years after initial diagnosis, an increased risk of developing pancreatic cancer (SIR: 1.90, p<0.05) and female genital tumors (SIR: 1.77, p<0.05) was observed. In patients who received radiation the only significantly increased risk was for “All Solid Tumors” (SIR: 1.42, p<0.05). No significant increase in second hematological malignancies was observed in the entire cohort, including cases that received radiation. Conclusions: An increased risk of second primary female genital tumors was seen in both the 5-10 years and >10 years latency periods. Pancreatic cancer risk was increased specifically in the >10 years latency period. Radiation treatment did not pose an increased risk for any specific second primary cancers. Interestingly, young adult CRC survivors did not have an increased risk for hematological malignancies compared to the general population.

The risk of second primary cancers in clear cell and papillary renal cancer.

2015 ◽  
Vol 33 (7_suppl) ◽  
pp. 446-446 ◽  
Author(s):  
Muhammad Saad Hamid ◽  
Raji Shameem ◽  
Rishi Jain ◽  
Kevin M. Sullivan
Keyword(s):  
Thyroid Cancer ◽  
Solid Tumors ◽  
Clear Cell ◽  
Latency Period ◽  
Initial Diagnosis ◽  
Second Primary ◽  
Second Primary Malignancy ◽  
Primary Malignancy ◽  
Second Primary Cancers ◽  
Increased Risk

446 Background: Renal cell carcinoma (RCC) survivors have an increased risk of developing second primary cancers. We sought to determine the role of RCC tumor histology for the risk of developing second primary solid tumors. Methods: The Surveillance Epidemiology and End Results (SEER) database was used to detect RCC cases diagnosed up to 12/31/2011. The Standardized Incidence Ratio (SIR) was calculated as the ratio of observed to expected cases of second primary malignancy based on incidence data in the general United States population. The two most common RCC histological subtypes were included; clear cell and papillary. The latency exclusion period from the date of diagnosis was 60 months. We investigated for the effect of latency period after initial diagnosis (5-10 years and >10 years) that may increase the risk for a second primary cancer. Results: A total of 2,669 patients with an initial diagnosis of RCC (clear cell: 2,368, papillary: 301) that developed second primary cancers were included in our analysis. There was a significantly increased risk of thyroid cancer (SIR: 2.30, p<0.05), prostate cancer (SIR: 1.12, p<0.05) and “all solid tumors” (SIR: 1.14, p<0.05) in clear cell RCC cases. Regarding latency period, thyroid cancer (SIR: 2.87, p<0.05) risk was increased in the 5-10 years latency period, but not in the >10 years latency period. Overall, in patients diagnosed with papillary RCC, tumors of the prostate (SIR: 1.30, p<0.05), lung (SIR: 1.78, p<0.05) and pancreas (SIR: 2.70, p<0.05) were increased. Exclusively in the 5-10 years latency period, the risk for developing lung cancer (SIR: 1.90, p<0.05) was significant. Conclusions: RCC histology may impact the risk for developing specific second primary solid tumors.

Analysis of second primary cancers in gastroinstestinal stromal tumor patients using SEER database.

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 327-327
Author(s):  
Krishna Bilas Ghimire ◽  
Barsha Nepal ◽  
Binay Kumar Shah
Keyword(s):  
General Population ◽  
Solid Tumors ◽  
Stromal Tumor ◽  
P Value ◽  
Second Primary ◽  
Seer Database ◽  
Second Primary Cancers ◽  
Increased Risk ◽  
Second Primary Malignancies ◽  
End Results

327 Background: Development of second primary cancers among gastrointestinal stromal tumor (GIST) patients is not very well studied. This study was conducted to evaluate second primary malignancies in GIST patients using U.S. Surveillance, Epidemiology, and End Results (SEER) cancer registry database. Methods: We analyzed the Surveillance, Epidemiology, and End Results (SEER Stat) database: Incidence - SEER 13 Regs Research Data, Nov 2011 Sub, Vintage 2009 Pops (1992-2009) using MP-SIR session. We analysed secondary cancer rate among adult GIST patients during the period 1992-2009. We also compared the risk of secondary malignancies in pre- (1992-2001) to post-imatinib (2002-2009) eras. We used SEER MP-SIR session and Graph pad scientific software to calculate p value. Results: There were 2,436 (693 in pre-imatinib era and 1,743 in post-imatinib era) GIST patients reported during 1992-2009 period in SEER database. Among them, 163 GIST patients developed second primary malignancy, which is significantly higher than expected in general population, with observed/expected (O/E) ratio: 1.31, p value = <0.05, (95% CI: 1.11-1.52) and excess risk of 39.76 per 10,000 population. The total number of second primary cancers in GIST in pre- and post-imatinib eras were 69 and 94, p value = <0.0001 with observed/expected (O/E) ratio of 29.18 and 48.22 respectively. The total number of second primary solid tumors in pre- and post-imatinib era was: 59 and 84, p value=0.0008 and O/E ratio: 20.18 vs 43.32 respectively. Conclusions: This study showed overall increased risk of second primary malignancies among GIST patients as compared to general population. There was significantly increased risk of second primary malignancies, especially solid tumors in post-imatinib era. [Table: see text]

Secondary primary cancers in male breast cancer survivors.

2014 ◽  
Vol 32 (26_suppl) ◽  
pp. 129-129 ◽  
Author(s):  
Raji Shameem ◽  
Muhammad S Hamid ◽  
Gaurang P Mavani ◽  
Nakul Singhal ◽  
Dana Shani ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Solid Tumors ◽  
Male Breast Cancer ◽  
Cancer Diagnosis ◽  
Latency Period ◽  
Breast Cancer Diagnosis ◽  
Initial Diagnosis ◽  
Male Breast ◽  
Age At Diagnosis ◽  
Increased Risk

129 Background: Male Breast Cancer (MBC) survivors have an increased risk of developing secondary contralateral breast cancer. However, the risk of developing other solid tumors and hematological malignancies is not well understood. Methods: The Surveillance Epidemiology and End Results (SEER) database was used to detect MBC cases diagnosed up to 12/31/2011. The Standardized Incidence Ratio (SIR) was calculated as the ratio of observed to expected cases of second primary malignancy based on incidence data in the general United States population. The latency exclusion period from the date of diagnosis was 5 years. We also investigated for any modifying effects such as radiation therapy, age at diagnosis, and latency period after initial diagnosis (5-10 years and >10 years) that may have increased the risk for secondary cancer. Results: A total of 1,239 men with an initial diagnosis of primary breast cancer were included in our analysis. Overall, there was an increased SIR of secondary solid tumors of the pharynx (SIR: 8.39, P<0.05), hypopharynx (SIR: 15.77, P<0.05), and brain (SIR: 4.40, p<0.05), and Non-Hodgkin Lymphoma (NHL) (SIR: 2.49, P<0.05), that was also seen in MBC cases that received radiation (24.1%), (SIR: 4.51, P<0.05). For MBC diagnoses in patients >40 years, there was an increased incidence for these malignancies and for “all solid tumors” (SIR: 1.30, P<0.05) as well. In the period ranging from 5-10 years after initial breast cancer diagnosis increased incidence for tumors of the pharynx (SIR: 8.95, P<0.05) and hypopharynx (SIR: 16.70, P<0.05) were seen. In contrast, there was no significant increased incidence of secondary cancers >10 years after initial diagnosis. Conclusions: MBC survivors are at increased risk for secondary malignancies of the pharynx, hypopharynx, brain, and NHL. Older age at diagnosis and radiation treatment appear to be risk factors. Risk of secondary tumors of the pharynx and hypopharynx is greatest 5-10 years after initial breast cancer diagnosis but optimal surveillance for MBC survivors requires further clarification.

scholarly journals Impact of Advanced Radiotherapy on Second Primary Cancer Risk in Prostate Cancer Survivors: A Nationwide Cohort Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Marie-Christina Jahreiß ◽  
Wilma D. Heemsbergen ◽  
Bo van Santvoort ◽  
Mischa Hoogeman ◽  
Maarten Dirkx ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Low Dose ◽  
External Beam Radiotherapy ◽  
Second Primary ◽  
Second Primary Cancers ◽  
Prostate Cancer Survivors ◽  
Netherlands Cancer Registry ◽  
Increased Risk ◽  
Dose Volumes

PurposeExternal Beam Radiotherapy (EBRT) techniques dramatically changed over the years. This may have affected the risk of radiation-induced second primary cancers (SPC), due to increased irradiated low dose volumes and scatter radiation. We investigated whether patterns of SPC after EBRT have changed over the years in prostate cancer (PCa) survivors.Materials and MethodsPCa survivors diagnosed between 1990-2014 were selected from the Netherlands Cancer Registry. Patients treated with EBRT were divided in three time periods, representing 2-dimensional Radiotherapy (RT), 3-dimensional conformal RT (3D-CRT), and the advanced RT (AdvRT) era. Standardized incidence ratios (SIR) and absolute excess risks (AER) were calculated to estimate relative and excess absolute SPC risks. Sub-hazard ratios (sHRs) were calculated to compare SPC rates between the EBRT and prostatectomy cohort. SPCs were categorized by subsite and anatomic region.ResultsPCa survivors who received EBRT had an increased risk of developing a solid SPC (SIR=1.08; 1.05-1.11), especially in patients aged &lt;70 years (SIR=1.13; 1.09-1.16). Pelvic SPC risks were increased (SIR=1.28; 1.23-1.34), with no obvious differences between the three EBRT eras. Non-pelvic SPC were only significantly increased in the AdvRT era (SIR=1.08; 1.02-1.14), in particular for the 1-5 year follow-up period. Comparing the EBRT cohort to the prostatectomy cohort, again an increased pelvic SPC risk was found for all EBRT periods (sHRs= 1.61, 1.47-1.76). Increased non-pelvic SPC risks were present for all RT eras and highest for the AdvRT period (sHRs=1.17, 1.06-1.29).ConclusionSPC risk in patients with EBRT is increased and remained throughout the different EBRT eras. The risk of developing a SPC outside the pelvic area changed unfavorably in the AdvRT era. Prolonged follow-up is needed to confirm this observation. Whether this is associated with increased irradiated low-dose volumes and scatter, or other changes in clinical EBRT practice, is the subject of further research.

scholarly journals Risks and cancer associations of metachronous and synchronous multiple primary cancers: a 25-year retrospective study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Pariyada Tanjak ◽  
Bhoom Suktitipat ◽  
Nutchavadee Vorasan ◽  
Panudeth Juengwiwattanakitti ◽  
Benjarat Thiengtrong ◽  
...  
Keyword(s):  
Head And Neck ◽  
Cancer Development ◽  
Multiple Primary Cancers ◽  
Second Primary ◽  
Primary Cancer ◽  
Second Primary Cancers ◽  
Genital Cancer ◽  
Multiple Primary ◽  
Female Genital ◽  
Male Genital

Abstract Background The situation of patients developing multiple primary cancers is becoming more frequent and graver. This study investigated the risks of developing second primary cancers that are related to first primary cancers, and the interval times of synchronous and metachronous multiple primary cancers. Patients and methods Retrospective data were retrieved from 109,054 patients aged ≥18 who were diagnosed with a first solid cancer and registered at Siriraj Cancer Center between 1991 and 2015. A two-month period between first- and second- primary cancers was used to differentiate metachronous and synchronous multiple primary cancers. The combinations of subsequent cancers and relative risks (RRs) of having multiple primary cancers versus having single primary cancer for the top-ten first and second primary cancers were examined. The RR was adjusted for age of the first primary cancer. A survival analysis of the time to second-primary-cancer development was performed. Results Multiple primary cancers were found in 1785 (1.63%) patients. Most (70.87%) second primary cancers occurred after 2 months of first breast, skin, colorectal, lung, head and neck, liver, male genital cancer–prostate, thyroid, and female genital cancer–non-uterine cancers, resulting in those cancers being classified as metachronous multiple primary cancer. After adjustment for age at first diagnosis, head and neck cancers had the highest metachronous association with second esophageal cancers (RR, 25.06; 95% CI, 13.41–50.77). Prostate cancer and second colorectal cancer also demonstrated a high metachronous association (RR, 2.00; 95% CI, 1.25–3.05). A strong synchronous association was found between uterine and ovarian cancers (RR, 27.77; 95% CI, 17.97–43.63). The median time from the first uterine cancer to second-cancer development was 55 days. Conclusions The top-ten most frequent multiple primary cancers were the following: breast; liver; head and neck; colorectal; male genital cancer–prostate; skin; female genital cancer–uterine; thyroid; lung; and female genital cancer–non-uterine. Second primary cancers showed specific associations that depended on the first primary cancer. Physicians should be cognizant of the most common combinations and the interval times of metachronous and synchronous multiple primary cancers.

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.

Characteristics and survival of secondary male breast cancer: SEER database analysis.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e13690-e13690
Author(s):  
John Khoury ◽  
Siddhartha Yadav ◽  
Tara Rangarajan ◽  
Dana Zakalik
Keyword(s):  
Breast Cancer ◽  
Male Breast Cancer ◽  
Hormone Receptors ◽  
Latency Period ◽  
Male Breast ◽  
Stage I ◽  
Second Primary ◽  
Second Primary Malignancy ◽  
Primary Malignancy ◽  
Increased Risk

e13690 Background: Male breast cancer (MBC) is rare accounting for less than 0.5% of all cancer diagnoses in men. We used the term secondary male breast cancer (sMBC) to refer to ipsilateral and contralateral recurrences in addition to new primary MBC. Given its low incidence, data regarding the risk of developing sMBC and its characteristics are scarce. Methods: Multiple Primary Standardized Incidence Ratios (MP-SIR) session was conducted from the SEER*Stat software. We included all patients diagnosed with stage I,II and III MBC between 1990 to 2015 from the Surveillance Epidemiology and End Results (SEER) 18 registry. The standardized incidence ratio (SIR) was calculated as an estimate of the risk of a second primary malignancy based on the incidence in the general population. Descriptive statistics and Kaplan-Meier analysis were performed using SPSS software. Results: Among all 2321 men diagnosed with a first primary MBC during the study period, 28 patients had a subsequent diagnosis of MBC. The risk of sMBC was significantly elevated with SIR of 33.12 (95% CI, 22.18 – 47.56). The median latency period between the initial and subsequent diagnoses was 5.9 years. 82.1% of the patients were White, 14.3% Black and 3.6% Asian/Pacific Islander. Majority of the cases constituting 85.7% of sMBC were diagnosed in the contralateral breast. 67.8% of the sMBC remained hormone receptors status positive similar to the initial status of the primary diagnosis. 42.9% of the sMBC patients were diagnosed with stage I, 17.9% with stage II, 3.6% with stage III, 17.9% with stage IV and 17.9% of unknown stage. The median overall survival for sMBC was 96 months (95% CI, 11.3-180.6). We also found an increased risk of developing liver cancer (SIR: 2.16), prostate cancer (SIR: 1.29), thyroid cancer (SIR: 3.08) and acute myeloid leukemia (SIR: 2.4) in individuals after a diagnosis of MBC. Conclusions: Men diagnosed with breast cancer are at increased risk of sMBC in addition to other malignancies which require careful monitoring after completing initial treatment. Contralateral mammogram screening or prophylactic contralateral mastectomy can be considered based on patient’s preferences and values.

Impact of the G8 score on the outcome of a cohort of elderly patients with solid or hematological malignancies.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 12038-12038
Author(s):  
Federica Biello ◽  
Alessia Mennitto ◽  
Abdurraouf Mahmoud ◽  
Francesca Platini ◽  
Daniela Ferrante ◽  
...  
Keyword(s):  
Overall Survival ◽  
Multivariate Analysis ◽  
Elderly Patients ◽  
Solid Tumors ◽  
Hematological Malignancies ◽  
Screening Tool ◽  
Tumor Type ◽  
Risk Of Death ◽  
Increased Risk ◽  
G8 Screening Tool

12038 Background: Elderly cancer patients may have important benefits from innovative treatments. However, they are often barred from clinical trials because of highly selective eligibility criteria, or due to biased and subjective physician standpoints including reluctance to invite elderly patients and fear of excessive toxicity. Indeed, geriatric assessment has been increasingly recognized as predictive and prognostic instrument to detect frailty in older adults with cancer. In this perspective, the G8 score is a simple and reproducible instrument to identify elderly patients who should undergo full geriatric evaluation. The aim of our study was to evaluate the impact of frailty assessment by the G8 screening tool on the outcome of onco-hematological patients. Methods: Between January 2017 and December 2020 the G8 screening tool was administered to patients, aged >65 years, referred to our center for solid and hematological malignancies. G8 score was assessed at the time of first access. The primary endpoint was overall survival. Multivariate analysis was performed according to G8 score, age, tumor type, stage and treatment. Results: In the observation period, 430 patients were screened for frailty by G8; median age was 77 years (65-92); of these, 331 (77%) had a G8 score <14. Pts with solid tumors were 310 (72%), 175 (57%) of whom had metastatic diseases; 227 (73%) had a G8 score <14. Pts with hematological malignancies were 120 (28%), 100 (83%) of whom had a G8 score <14. Systemic therapy was administered to 336 patients (78%). At a median follow up of 7.2 months (range 1 to 52) 101 pts (24%) were dead. Median overall survival (mOS) was 27 months (1-52+).Patients with solid tumors, classified as frail by a G8 score <14 had a 3-fold risk of death compared with those with G8 > 14 (OR 3.26, CI 95 1.5-7.2, p = 0.003). Conversely, this increased risk was not observed in hematological malignancies (OR 1.4, CI 95 0.4-4.6, p = 0.57). By multivariate analysis, G8 score was associated with a worse prognosis only in patients with solid tumors. Conclusions: Our analysis suggest that elderly frail patients with solid tumors have a significantly increased risk of death as compared to elderly fit patients. Conversely, no impact of frailty, as assessed by a G8 score < 14, was evident in elderly patients with hematological malignancies.

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