Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, Massachusetts.
Harvard Medical School, Boston, Massachusetts.
Cancer. 2015 Jul 1;121(13):2230-6. doi: 10.1002/cncr.29334. Epub 2015 Mar 10.
Waldenström macroglobulinemia (WM) is an indolent malignancy that predominantly affects older individuals who are at risk for secondary malignancies (SMs). The objective of this study was to characterize the incidence of SMs after a diagnosis of WM with the Surveillance, Epidemiology, and End Results (SEER) database.
With SEER-13 data (1992-2011), standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) were calculated for the rates of solid and hematologic SMs in WM patients versus the general population. The analysis was stratified by age, sex, race, year of diagnosis, and latency from the WM diagnosis.
Among 4676 patients with WM, 681 SMs were recorded. The overall SIR was 1.49 (95% CI, 1.38-1.61), and the median time to an SM was 3.7 years. The cumulative incidence of SMs was 10% at 5 years and 16% at 10 years. The risk was significantly increased for cancers of the lungs, urinary tract, and thyroid; melanoma; aggressive lymphoma; and acute leukemia. The SIR for SMs in patients with WM was increased, regardless of age, sex, race, or year of diagnosis.
Patients with WM had a 49% higher risk of SMs than the general population. The selectively increased risk for hematologic SMs and certain solid SMs may be associated with transformation, therapy, and immune dysregulation.
华氏巨球蛋白血症（WM）是一种惰性恶性肿瘤，主要影响有发生继发性恶性肿瘤（SMs）风险的老年人。本研究的目的是使用监测、流行病学和最终结果（SEER）数据库来描述 WM 诊断后的 SMs 发生率。
利用 SEER-13 数据（1992-2011 年），计算 WM 患者与普通人群中实体和血液学 SMs 的标准化发病比（SIRs）及其 95%置信区间（CIs）。分析按年龄、性别、种族、诊断年份和 WM 诊断后潜伏期进行分层。
在 4676 例 WM 患者中，记录到 681 例 SMs。总的 SIR 为 1.49（95%CI，1.38-1.61），SM 出现的中位时间为 3.7 年。SM 的累积发生率在 5 年内为 10%，在 10 年内为 16%。患有肺癌、泌尿道癌和甲状腺癌、黑色素瘤、侵袭性淋巴瘤和急性白血病的风险显著增加。WM 患者发生 SMs 的风险增加，与年龄、性别、种族或诊断年份无关。
WM 患者发生 SMs 的风险比普通人群高 49%。血液学 SMs 和某些实体 SMs 的选择性增加风险可能与转化、治疗和免疫失调有关。
