Chen Tianhui, Fallah Mahdi, Brenner Hermann, Jansen Lina, Mai Elias K, Castro Felipe A, Katalinic Alexander, Emrich Katharina, Holleczek Bernd, Geiss Karla, Eberle Andrea, Sundquist Kristina, Hemminki Kari
Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Institute of Occupational Diseases Prevention, Zhejiang Academy of Medical Sciences, Hangzhou, China.
Sci Rep. 2016 Feb 24;6:22084. doi: 10.1038/srep22084.
We aimed at investigating the distribution and risk of second primary cancers (SPCs) in multiple myeloma (MM) survivors in Germany and Sweden to provide etiological understanding of SPCs and insight into their incidence rates and recording practices. MM patients diagnosed in 1997-2010 at age ≥15 years were selected from the Swedish (nationwide) and 12 German cancer registries. Standardized incidence ratios (SIRs) were used to assess risk of a specific SPC compared to risk of the same first cancer in the corresponding background population. Among 18,735 survivors of first MM in Germany and 7,560 in Sweden, overall 752 and 349 SPCs were recorded, respectively. Significantly elevated SIRs of specific SPCs were observed for acute myeloid leukemia (AML; SIR = 4.9) in Germany and for kidney cancer (2.3), AML (2.3) and nervous system cancer (1.9) in Sweden. Elevated risk for AML was more pronounced in the earlier diagnosis period compared to the later, i.e., 9.7 (4.2-19) for 1997-2003 period versus 3.5 (1.5-6.9) for 2004-2010 in Germany; 3.8 (1.4-8.3) for 1997-2003 versus 2.2 (0.3-7.8) for 2004-2010 in Sweden. We found elevated risk for AML for overall, early diagnosis periods and longer follow-up times in both populations, suggesting possible side effects of treatment for MM patients.
我们旨在调查德国和瑞典多发性骨髓瘤（MM）幸存者中第二原发性癌症（SPC）的分布和风险，以提供对SPC的病因学理解，并深入了解其发病率和记录方式。从瑞典（全国范围）和12个德国癌症登记处选取了1997年至2010年诊断出的年龄≥15岁的MM患者。标准化发病率（SIR）用于评估特定SPC的风险与相应背景人群中相同第一癌症风险的比较。在德国的18735名首次患MM的幸存者和瑞典的7560名幸存者中，分别记录了752例和349例SPC。在德国，急性髓系白血病（AML；SIR = 4.9）的特定SPC的SIR显著升高，在瑞典，肾癌（2.3）、AML（2.3）和神经系统癌症（1.9）的SIR显著升高。与后期相比，AML的风险升高在早期诊断期更为明显，即在德国，1997 - 2003年期间为9.7（4.2 - 19），而2004 - 2010年为3.5（1.5 - 6.9）；在瑞典，1997 - 2003年为3.8（1.4 - 8.3），而2004 - 2010年为2.2（0.3 - 7.8）。我们发现，在这两个人群中，总体、早期诊断期和较长随访期的AML风险均升高，这表明MM患者的治疗可能存在副作用。
