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Treatment-related r...
Treatment-related risk factors for transformation to acute myeloid leukemia and myelodysplastic syndromes in myeloproliferative neoplasms
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- Bjorkholm, M. (författare)
- Karolinska Institutet,Karolinska University Hospital Solna, Karolinska Institutet, Stockholm, Sweden, Swedish Chronic Myeloproliferative Neoplasm Study Group, Stockholm, Sweden
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- Derolf, A.R. (författare)
- Karolinska Institutet,Karolinska University Hospital Solna, Karolinska Institutet, Stockholm, Sweden
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- Hultcrantz, M. (författare)
- Karolinska Institutet,Karolinska University Hospital Solna, Karolinska Institutet, Stockholm, Sweden, Swedish Chronic Myeloproliferative Neoplasm Study Group, Stockholm, Sweden
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- Kristinsson, S.Y. (författare)
- Karolinska Institutet,Karolinska University Hospital Solna, Karolinska Institutet, Stockholm, Sweden
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- Ekstrand, C. (författare)
- Karolinska Institutet,Karolinska University Hospital Solna, Karolinska Institutet, Stockholm, Sweden
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- Goldin, L.R. (författare)
- National Cancer Institute, National Institutes of Health, Bethesda, MD, United States
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- Andreasson, B. (författare)
- Swedish Chronic Myeloproliferative Neoplasm Study Group, Stockholm, Sweden
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- Birgegård, Gunnar (författare)
- Uppsala universitet,Institutionen för medicinska vetenskaper,Blodsjukdomar,Swedish Chronic Myeloproliferative Neoplasm Study Group, Stockholm, Sweden
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- Linder, O. (författare)
- Swedish Chronic Myeloproliferative Neoplasm Study Group, Stockholm, Sweden
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- Malm, Claes (författare)
- Östergötlands Läns Landsting,Linköpings universitet,Onkologi,Hälsouniversitetet,Hematologiska kliniken US,Swedish Chronic Myeloproliferative Neoplasm Study Group, Stockholm, Sweden
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- Markevarn, B. (författare)
- Swedish Chronic Myeloproliferative Neoplasm Study Group, Stockholm, Sweden
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- Nilsson, L. (författare)
- Swedish Chronic Myeloproliferative Neoplasm Study Group, Stockholm, Sweden
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- Samuelsson, J. (författare)
- Karolinska Institutet,Swedish Chronic Myeloproliferative Neoplasm Study Group, Stockholm, Sweden
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- Granath, F. (författare)
- Karolinska Institutet,Karolinska University Hospital Solna, Karolinska Institutet, Stockholm, Sweden
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- Landgren, O. (författare)
- Karolinska University Hospital Solna, Karolinska Institutet, Stockholm, Sweden, National Cancer Institute, National Institutes of Health, Bethesda, MD, United States
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(creator_code:org_t)
- American Society of Clinical Oncology: JCO, 2011
- 2011
- Engelska.
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Ingår i: Journal of Clinical Oncology. - : American Society of Clinical Oncology: JCO. - 0732-183X .- 1527-7755. ; 29:17, s. 2410-2415
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Purpose: Patients with myeloproliferative neoplasms (MPNs), including polycythemia vera, essential thrombocythemia, and primary myelofibrosis, have a propensity to develop acute myeloid leukemia (AML) and myelodysplastic syndromes (MDSs). Using population-based data from Sweden, we assessed the role of MPN treatment and subsequent AML/MDS risk with special focus on the leukemogenic potential of hydroxyurea (HU). Methods: On the basis of a nationwide MPN cohort (N = 11,039), we conducted a nested case-control study, including 162 patients (153 and nine with subsequent AML and MDS diagnosis, respectively) and 242 matched controls. We obtained clinical and MPN treatment data for all patients. Using logistic regression, we calculated odds ratios (ORs) as measures of AML/MDS risk. Results: Forty-one (25%) of 162 patients with MPNs with AML/MDS development were never exposed to alkylating agents, radioactive phosphorous (P32), or HU. Compared with patients with who were not exposed to HU, the ORs for 1 to 499 g, 500 to 999 g, more than 1,000 g of HU were 1.5 (95% CI, 0.6 to 2.4), 1.4 (95% CI, 0.6 to 3.4), and 1.3 (95% CI, 0.5 to 3.3), respectively, for AML/MDS development (not significant). Patients with MPNs who received P32 greater than 1,000 MBq and alkylators greater than 1 g had a 4.6-fold (95% CI, 2.1 to 9.8; P = .002) and 3.4-fold (95% CI, 1.1 to 10.6; P = .015) increased risk of AML/MDS, respectively. Patients receiving two or more cytoreductive treatments had a 2.9-fold (95% CI, 1.4 to 5.9) increased risk of transformation. Conclusion: The risk of AML/MDS development after MPN diagnosis was significantly associated with high exposures of P32 and alkylators but not with HU treatment. Twenty-five percent of patients with MPNs who developed AML/MDS were not exposed to cytotoxic therapy, supporting a major role for nontreatment-related factors. © 2011 by American Society of Clinical Oncology.
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- MEDICIN
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Bjorkholm, M.
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Derolf, A.R.
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Hultcrantz, M.
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Kristinsson, S.Y ...
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Ekstrand, C.
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Goldin, L.R.
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Andreasson, B.
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Birgegård, Gunna ...
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Linder, O.
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Malm, Claes
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Markevarn, B.
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Nilsson, L.
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Samuelsson, J.
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Granath, F.
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Landgren, O.
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- Artiklar i publikationen
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Journal of Clini ...
- Av lärosätet
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Linköpings universitet
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Uppsala universitet
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Karolinska Institutet