Hussein Mohammad H, Toraih Eman, Jishu Jessan A, Lavorgna Tessa, Abdelmaksoud Ahmed, Craig Ryan, Kandil Emad
Division of Endocrine and Oncologic Surgery, Department of Surgery, School of Medicine, Tulane University, New Orleans, LA 70112, USA.
Ochsner Clinic Foundation, New Orleans, LA 70112, USA.
Cancers (Basel). 2024 Dec 25;17(1):25. doi: 10.3390/cancers17010025.
Radioactive iodine (RAI) ablation therapy is a common minimally invasive treatment for patients diagnosed with differentiated thyroid cancer (DTC). Although previous studies have identified a link between RAI and the mortality from secondary solid cancers, the connection between RAI and leukemia remains under-researched. This study investigated the differential risk of leukemia and its subtypes in DTC patients following RAI treatment. DTC patients from the Surveillance, Epidemiology, and End Results (SEER) Registry 17 (2000-2019) were analyzed. The standard incidence ratio (SIR) and excess risk (ER) compared to the reference population were calculated. Out of 196,569 DTC patients, 1381 patients developed various types of hematological malignancies. Leukemia was diagnosed in 508 of these patients, and it had the highest risk among the malignancies studied, with an SIR of 1.74 (95%CI: 1.59-1.9). The RAI group had an SIR of 2.12 (95%CI: 1.87-2.39), while the non-RAI group had an SIR was 1.45 (95%CI: 1.37-1.52) ( < 0.001). Those diagnosed before the age of 55 years had a conspicuously elevated risk (SIR 2.74) compared to those diagnosed at 55 years or older (SIR 1.53). American Indian/Alaska Native survivors manifested a pronounced leukemia risk with an SIR of 7.63 (95%CI: 2.46-17.8). RAI treatment increased the risk of developing leukemia when serving as adjuvant therapy in surgical patients (SIR 2.12). There exists a significant association between RAI treatment in DTC patients and the incidence of leukemia. This susceptibility seems to be modulated by factors including time since diagnosis, age, gender, and racial background.
放射性碘（RAI）消融治疗是诊断为分化型甲状腺癌（DTC）患者的一种常见微创治疗方法。尽管先前的研究已经确定了RAI与继发性实体癌死亡率之间的联系，但RAI与白血病之间的关联仍研究不足。本研究调查了RAI治疗后DTC患者患白血病及其亚型的差异风险。对监测、流行病学和最终结果（SEER）登记处17（2000 - 2019年）的DTC患者进行了分析。计算了与参考人群相比的标准发病率比（SIR）和超额风险（ER）。在196,569例DTC患者中，1381例患者发生了各种类型的血液系统恶性肿瘤。其中508例患者被诊断为白血病，在研究的恶性肿瘤中其风险最高，SIR为1.74（95%CI：1.59 - 1.9）。RAI组的SIR为2.12（95%CI：1.87 - 2.39），而非RAI组的SIR为1.45（95%CI：1.37 - 1.52）（<0.001）。与55岁及以上确诊的患者（SIR 1.53）相比，55岁之前确诊的患者风险显著升高（SIR 2.74）。美国印第安人/阿拉斯加原住民幸存者表现出明显的白血病风险，SIR为7.63（95%CI：2.46 - 17.8）。RAI治疗作为手术患者的辅助治疗时会增加患白血病的风险（SIR 2.12）。DTC患者接受RAI治疗与白血病发病率之间存在显著关联。这种易感性似乎受到诊断后的时间、年龄、性别和种族背景等因素的调节。
