Shah Binay Kumar, Ghimire Krishna Bilas
Cancer Center and Blood Institute, St. Joseph Regional Medical Center, 1250 Idaho Street, Lewiston, ID 83501 USA.
Mercy Medical Center - North Iowa, Mason City, IA USA.
Indian J Hematol Blood Transfus. 2014 Dec;30(4):236-40. doi: 10.1007/s12288-013-0328-2. Epub 2014 Jan 23.
Survival of patients with chronic myeloid leukemia (CML) has improved with the use of imatinib and other tyrosine kinase inhibitors. There is limited data on second primary malignancies (SPM) in CML. We analyzed the SPMs rates among CML patients reported to Surveillance, Epidemiology, and End Results (SEER) database during pre-(1992-2000) and post-(2002-2009) era. We used SEER Multiple Primary-Standardized Incidence Ratio session to calculate standardized incidence ratios (SIRs). Among 8,511 adult CML patients, 446 patients developed 473 SPMs. The SIR for SPMs in CML patients was significantly higher with observed/expected ratio:1.27, P < 0.05 and absolute excess risk of 32.09 per 10,000 person years compared to general population. The rate of SPMs for cancers of all sites in post-imatinib era were significantly higher compared to pre-imatinib era with observed/expected ratio of 1.48 versus 1.06, P = 0.03. This study showed that risk of SPMs is higher among CML patients. The risk of SPMs is significantly higher in post-imatinib era compared to pre-imatinib era.
慢性髓性白血病（CML）患者使用伊马替尼和其他酪氨酸激酶抑制剂后生存率有所提高。关于CML患者中第二原发性恶性肿瘤（SPM）的数据有限。我们分析了在监测、流行病学和最终结果（SEER）数据库中报告的CML患者在（1992 - 2000年）之前和（2002 - 2009年）之后这两个时期的SPM发生率。我们使用SEER多重原发性标准化发病率比程序来计算标准化发病率（SIR）。在8511例成年CML患者中，446例患者发生了473例SPM。CML患者中SPM的SIR显著高于观察/预期比值：1.27，P < 0.05，与一般人群相比，每10000人年的绝对超额风险为32.09。与伊马替尼使用前的时期相比，伊马替尼使用后的时期所有部位癌症的SPM发生率显著更高，观察/预期比值为1.48对1.06，P = 0.03。这项研究表明，CML患者中SPM的风险更高。与伊马替尼使用前的时期相比，伊马替尼使用后的时期SPM的风险显著更高。
