Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Sourasky Medical Center, Institute of Hematology, Tel-Aviv, Israel.
Leuk Lymphoma. 2020 Nov;61(11):2638-2644. doi: 10.1080/10428194.2020.1779257. Epub 2020 Jul 1.
It is unknown whether rituximab increases the risk of second primary malignancies (SPMs) in patients with diffuse large cell B-cell lymphoma (DLBCL). We assessed SPMs in DLBCL patients diagnosed between 1996 and 2014 in comparison with the general Israeli population and dependent on rituximab treatment. Jewish patients had no increased risk for SPMs. Arab-DLBCL females had a higher SPMs rate compared to the general Arab-females population [SIR (95%CI) 1.86 (1.08-2.98)]. Incidence and time to SPMs, in both Jewish and Arab patients, were unaffected by rituximab. Risk for breast and thyroid cancers, in Arab and Jewish females respectively, were higher in the pre-rituximab era [SIR(95%CI) 5.25 (1.41-13.43) and SIR(95%CI) 3.85 (1.41-8.38), respectively]. Age ≥60 years was the only predictor for increased risk of SPM (HR = 2.5, < .01). The increased risk of SPMs in specific subgroups of patients that were treated in the pre-rituximab era may reflect stringent medical surveillance employed in these populations.
尚不清楚利妥昔单抗是否会增加弥漫性大 B 细胞淋巴瘤（DLBCL）患者发生第二原发恶性肿瘤（SPMs）的风险。我们评估了 1996 年至 2014 年间诊断为 DLBCL 的患者与普通以色列人群相比，以及与利妥昔单抗治疗相关的 SPMs 风险。犹太患者发生 SPMs 的风险没有增加。与普通阿拉伯女性人群相比，阿拉伯裔 DLBCL 女性的 SPMs 发生率更高[标化发病率比（SIR）（95%CI）为 1.86（1.08-2.98)]。在犹太人和阿拉伯患者中，无论是在利妥昔单抗治疗前后，SPMs 的发生率和时间均不受影响。在阿拉伯裔和犹太裔女性中，乳腺癌和甲状腺癌的风险在利妥昔单抗治疗前更高[SIR（95%CI）分别为 5.25（1.41-13.43）和 3.85（1.41-8.38)]。年龄≥60 岁是 SPM 风险增加的唯一预测因素（HR=2.5，<0.01）。在利妥昔单抗治疗前接受治疗的特定患者亚组中 SPMs 风险增加可能反映了这些人群中采用的严格医疗监测。
