骨髓增殖性肿瘤患者发生第二恶性肿瘤的发病率和危险因素。

Incidence and risk factors for second malignancies among patients with myeloproliferative neoplasms.

机构信息

Department of Hematology, The Second Hospital of Tianjin Medical University, Tianjin, China.

State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, National Clinical Research Center for Blood Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China.

出版信息

Cancer Med. 2023 Apr;12(8):9236-9246. doi: 10.1002/cam4.5666. Epub 2023 Feb 2.

DOI:10.1002/cam4.5666

PMID:36727544

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10166886/

Abstract

OBJECTIVE

The clinical characteristics and survival of patients with myeloproliferative neoplasms (MPNs) with secondary cancer were analyzed to explore the possible risk factors for secondary cancer in MPN patients.

METHODS

The clinical characteristics of 1060 Chinese patients with MPN were retrospectively analyzed. The Kaplan-Meier method was used to analyze the survival. The Cox multivariate regression model was used to analyze the risk factors for developing secondary cancer in patients with MPNs.

RESULTS

The 1060 patients with MPN had a median follow-up of 10 years (range 1-50) and a median age of 55 years (range 21-86), and 497 (45.2%) were male. The proportion of PV, ET, and PMF was 52.2%, 33.5%, and 14.3%, respectively. About 28.1% (298/1060) of 1060 MPN patients died. The median survival times of the PV, ET, and PMF groups were 20, 24, and 12 years, respectively (p < 0.0001). In age- and sex-matched healthy Chinese patients, the standardized incidence ratio (SIR) value of developing secondary cancer in MPN patients was 6.41 (95% CI: 4.90-9.48). The median survival time was 14 years in the MPN with secondary cancer group. The Cox multivariate analysis showed that age ≥ 65 years (p < 0.0001, HR = 5.027, 95% CI [2.823, 8.952]), MF-1 (p = 0.001, HR = 2.887, 95% CI [1.503, 5.545]) were risk factors for developing secondary cancer.

CONCLUSIONS

The survival of MPN patients with secondary cancer was significantly worse than that of patients without secondary cancer. Compared with normal subjects, MPN patients had a 6.41-fold increased risk of developing secondary cancer, and age ≥ 65 years and MF-1 were risk factors for developing secondary cancer in MPN patients.

摘要

目的

分析伴发继发性癌症的骨髓增殖性肿瘤（MPN）患者的临床特征和生存情况，探讨 MPN 患者发生继发性癌症的可能危险因素。

方法

回顾性分析 1060 例中国 MPN 患者的临床特征。采用 Kaplan-Meier 法分析生存情况，采用 Cox 多因素回归模型分析 MPN 患者发生继发性癌症的危险因素。

结果

1060 例 MPN 患者的中位随访时间为 10 年（范围 1-50 年），中位年龄为 55 岁（范围 21-86 岁），其中 497 例（45.2%）为男性。PV、ET 和 PMF 的比例分别为 52.2%、33.5%和 14.3%。1060 例 MPN 患者中有 28.1%（298/1060）死亡。PV、ET 和 PMF 组的中位生存时间分别为 20、24 和 12 年，差异有统计学意义（p<0.0001）。在年龄和性别匹配的健康中国人群中，MPN 患者发生继发性癌症的标准化发病比（SIR）值为 6.41（95%CI：4.90-9.48）。伴发继发性癌症的 MPN 患者的中位生存时间为 14 年。Cox 多因素分析显示，年龄≥65 岁（p<0.0001，HR=5.027，95%CI[2.823,8.952]）、MF-1（p=0.001，HR=2.887，95%CI[1.503,5.545]）是发生继发性癌症的危险因素。