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Geurts, Y.M.; Neppelenbroek, S.I.M.; Aleman, B.M.P.; Janus, C.P.M.; Krol, A.D.G.; van Spronsen, D.J.; Plattel, W.J.; Roesink, J.M.; Verschueren, K.M.S.; Zijlstra, J.M.; Koene, H.R.; Nijziel, M.R.; Schimmel, E.C.; de Jongh, E.; Ong, F.; te Boome, L.C.J.; van Rijn, R.S.; Böhmer, L.H.; Ta, B.D.P.; Visser, H.P.J.; Posthuma, E.F.M.; Bilgin, Y.M.; Muller, K.; van Kampen, D.; So-Osman, C.; Vermaat, J.S.P.; de Weijer, R.J.; Kersten, M.J.; van Leeuwen, F.E.; Schaapveld, M.
ESMO open, 02/2024, Letnik: 9, Številka: 2Journal Article
The introduction of rituximab significantly improved the prognosis of diffuse large B-cell lymphoma (DLBCL), emphasizing the importance of evaluating the long-term consequences of exposure to radiotherapy, alkylating agents and anthracycline-containing (immuno)chemotherapy among DLBCL survivors. Long-term risk of subsequent malignant neoplasms (SMNs) was examined in a multicenter cohort comprising 2373 5-year DLBCL survivors treated at ages 15-61 years in 1989-2012. Observed SMN numbers were compared with expected cancer incidence to estimate standardized incidence ratios (SIRs) and absolute excess risks (AERs/10 000 person-years). Treatment-specific risks were assessed using multivariable Cox regression. After a median follow-up of 13.8 years, 321 survivors developed one or more SMNs (SIR 1.5, 95% CI 1.3-1.8, AER 51.8). SIRs remained increased for at least 20 years after first-line treatment (SIR ≥20-year follow-up 1.5, 95% CI 1.0-2.2, AER 81.8) and were highest among patients ≤40 years at first DLBCL treatment (SIR 2.7, 95% CI 2.0-3.5). Lung (SIR 2.0, 95% CI 1.5-2.7, AER 13.4) and gastrointestinal cancers (SIR 1.5, 95% CI 1.2-2.0, AER 11.8) accounted for the largest excess risks. Treatment with >4500 mg/m2 cyclophosphamide/>300 mg/m2 doxorubicin versus ≤2250 mg/m2/≤150 mg/m2, respectively, was associated with increased solid SMN risk (hazard ratio 1.5, 95% CI 1.0-2.2). Survivors who received rituximab had a lower risk of subdiaphragmatic solid SMNs (hazard ratio 0.5, 95% CI 0.3-1.0) compared with survivors who did not receive rituximab. Five-year DLBCL survivors have an increased risk of SMNs. Risks were higher for survivors ≤40 years at first treatment and survivors treated with >4500 mg/m2 cyclophosphamide/>300 mg/m2 doxorubicin, and may be lower for survivors treated in the rituximab era, emphasizing the need for studies with longer follow-up for rituximab-treated patients. •Five-year DLBCL survivors have a higher risk of subsequent solid and hematological malignancies than the general population.•Largest excess risks were observed for subsequent lung and gastrointestinal tract cancer.•Receipt of >4500 mg/m2 cyclophosphamide (versus ≤2250 mg/m2) is associated with a 1.5-fold increased solid malignancy risk.•Risk may be lower for survivors treated in the rituximab era, emphasizing the need for studies with longer follow-up.
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Dostop do baze podatkov JCR je dovoljen samo uporabnikom iz Slovenije. Vaš trenutni IP-naslov ni na seznamu dovoljenih za dostop, zato je potrebna avtentikacija z ustreznim računom AAI.
Leto | Faktor vpliva | Izdaja | Kategorija | Razvrstitev | ||||
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JCR | SNIP | JCR | SNIP | JCR | SNIP | JCR | SNIP |
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Povezave do osebnih bibliografij avtorjev | Povezave do podatkov o raziskovalcih v sistemu SICRIS |
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Vir: Osebne bibliografije
in: SICRIS
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