The risk of developing acute non-lymphocytic leukemia in women with breast cancer.

BACKGROUND

This study had the purpose of examining the incidences, risk factors, and survival outcome of developing subsequent acute non-lymphocytic leukemia (ANLL) among a large group of breast cancer survivors.

METHODS

We analyzed data from the Surveillance, Epidemiology, and End Results (SEER) program for standardized incidence ratio (SIR), risk factors, and survival of subsequent ANLL, focusing on the period between 2000 and 2014.

RESULTS

There was an increased SIR among breast cancer patients for subsequent ANLL (SIR: 2.41; 95% CI: 2.26-2.58). Risk factors of subsequent ANLL were age at first cancer diagnosis (40+ 15-39 years, aHR =1.572, P=0.003), tumor size (21-50 ≤20 mm, aHR =1.332, P=0.003; 50+ ≤20 mm, aHR =1.735, P<0.001), chemotherapy exposure (yes no, aHR =1.692, P<0.001), and radiation exposure (yes no, aHR =1.232, P=0.002). Meanwhile, following subsequent ANLL, survivors had an adverse overall survival (OS) compared with patients who did not develop ANLL (aHR =3.359, P<0.001).

CONCLUSIONS

Breast cancer survivors have a higher risk of developing subsequent ANLL compared to the general population. Increased vigilance should be shown towards the potential development of ANLL due to older age, larger tumor size, chemotherapy, and radiation exposure in survivors.