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Risk of new malignancies among patients with CLL treated with chemotherapy: results of a Danish population-based study

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@article{5e940faaa1604842bd9a2ec8194fd8fe,
title = "Risk of new malignancies among patients with CLL treated with chemotherapy: results of a Danish population-based study",
abstract = "Patients with chronic lymphocytic leukaemia (CLL) have an increased risk of new malignancies. However, limited data have been published about the impact of CLL treatment on this risk. Here we followed a Danish population-based cohort of CLL patients for risks of new malignancies. Patients in the Danish CLL registry (2008-2017) were included. Up to 50 CLL-free matched comparators were identified. First-line treatment was categorized into four groups; bendamustine, chlorambucil, fludarabine or other. Patients were followed from CLL diagnosis for individual types of malignancy. Adjusted hazard ratios (HR) for new malignancies and 95% confidence intervals (95% CI) were calculated. Overall, 4286 CLL patients and 214 150 controls developed 594 and 20 565 new malignancies respectively. Risk of new malignancies was increased for CLL patients. Chemotherapy treatment was registered for 1064 (25%) patients with CLL. Chemotherapy was associated with increased HR (1·51, 95% CI: 1·3-1·8) of any new malignancy. Specifically, fludarabine was associated with an increased risk of myelodysplastic syndrome (MDS) (HR 4·93, 95% CI: 1·2-19·8). Patients with CLL are at increased risk of other haematological and solid malignancies compared to the general population. Chemotherapy exposure is associated with increased risk of second malignancies and fludarabine is associated with increased risk of MDS.",
keywords = "Chemotherapy, Chronic lymphocytic leukaemia, MDS",
author = "{da Cunha-Bang}, Caspar and Klaus Rostgaard and Andersen, {Michael A} and Rotbain, {Emelie C} and Kirsten Gr{\o}nbaek and Henrik Frederiksen and Niemann, {Carsten U} and Henrik Hjalgrim",
note = "{\textcopyright} 2021 British Society for Haematology and John Wiley & Sons Ltd.",
year = "2021",
month = apr,
doi = "10.1111/bjh.17337",
language = "English",
volume = "193",
pages = "339--345",
journal = "British Journal of Haematology",
issn = "0007-1048",
publisher = "Wiley-Blackwell Publishing Ltd",
number = "2",

}

RIS

TY - JOUR

T1 - Risk of new malignancies among patients with CLL treated with chemotherapy

T2 - results of a Danish population-based study

AU - da Cunha-Bang, Caspar

AU - Rostgaard, Klaus

AU - Andersen, Michael A

AU - Rotbain, Emelie C

AU - Grønbaek, Kirsten

AU - Frederiksen, Henrik

AU - Niemann, Carsten U

AU - Hjalgrim, Henrik

N1 - © 2021 British Society for Haematology and John Wiley & Sons Ltd.

PY - 2021/4

Y1 - 2021/4

N2 - Patients with chronic lymphocytic leukaemia (CLL) have an increased risk of new malignancies. However, limited data have been published about the impact of CLL treatment on this risk. Here we followed a Danish population-based cohort of CLL patients for risks of new malignancies. Patients in the Danish CLL registry (2008-2017) were included. Up to 50 CLL-free matched comparators were identified. First-line treatment was categorized into four groups; bendamustine, chlorambucil, fludarabine or other. Patients were followed from CLL diagnosis for individual types of malignancy. Adjusted hazard ratios (HR) for new malignancies and 95% confidence intervals (95% CI) were calculated. Overall, 4286 CLL patients and 214 150 controls developed 594 and 20 565 new malignancies respectively. Risk of new malignancies was increased for CLL patients. Chemotherapy treatment was registered for 1064 (25%) patients with CLL. Chemotherapy was associated with increased HR (1·51, 95% CI: 1·3-1·8) of any new malignancy. Specifically, fludarabine was associated with an increased risk of myelodysplastic syndrome (MDS) (HR 4·93, 95% CI: 1·2-19·8). Patients with CLL are at increased risk of other haematological and solid malignancies compared to the general population. Chemotherapy exposure is associated with increased risk of second malignancies and fludarabine is associated with increased risk of MDS.

AB - Patients with chronic lymphocytic leukaemia (CLL) have an increased risk of new malignancies. However, limited data have been published about the impact of CLL treatment on this risk. Here we followed a Danish population-based cohort of CLL patients for risks of new malignancies. Patients in the Danish CLL registry (2008-2017) were included. Up to 50 CLL-free matched comparators were identified. First-line treatment was categorized into four groups; bendamustine, chlorambucil, fludarabine or other. Patients were followed from CLL diagnosis for individual types of malignancy. Adjusted hazard ratios (HR) for new malignancies and 95% confidence intervals (95% CI) were calculated. Overall, 4286 CLL patients and 214 150 controls developed 594 and 20 565 new malignancies respectively. Risk of new malignancies was increased for CLL patients. Chemotherapy treatment was registered for 1064 (25%) patients with CLL. Chemotherapy was associated with increased HR (1·51, 95% CI: 1·3-1·8) of any new malignancy. Specifically, fludarabine was associated with an increased risk of myelodysplastic syndrome (MDS) (HR 4·93, 95% CI: 1·2-19·8). Patients with CLL are at increased risk of other haematological and solid malignancies compared to the general population. Chemotherapy exposure is associated with increased risk of second malignancies and fludarabine is associated with increased risk of MDS.

KW - Chemotherapy

KW - Chronic lymphocytic leukaemia

KW - MDS

UR - http://www.scopus.com/inward/record.url?scp=85100857191&partnerID=8YFLogxK

U2 - 10.1111/bjh.17337

DO - 10.1111/bjh.17337

M3 - Journal article

C2 - 33570184

VL - 193

SP - 339

EP - 345

JO - British Journal of Haematology

JF - British Journal of Haematology

SN - 0007-1048

IS - 2

ER -

ID: 62113273