Influencing factors of secondary primary cancer in patients with acute lymphoid leukemia
10.3969/j.issn.1006-2483.2023.01.006
- VernacularTitle:急性淋巴性白血病患者发生第二原发癌症的影响因素分析
- Author:
Yun-qin JIN
1
;
Hai-hong JIANG
1
;
Jing YU
1
;
Na-na LIU
1
;
Hong WANG
1
Author Information
1. Department of Labor and Environmental Hygiene, School of Public Health, Ministry of Medicine, Wuhan University , Wuhan , Hubei 430071 , China
- Publication Type:Journal Article
- Keywords:
Leukemia;
Second primary cancer;
Surveillance, Epidemiology and End Results database
- From:
Journal of Public Health and Preventive Medicine
2023;34(1):25-30
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the influencing factors of second primary cancer (SPC) in patients with acute lymphoblastic leukemia (ALL). Methods The Surveillance, Epidemiology and End Results database of the National Cancer Institute was used to extract data, and SEER*Stat program 8.4.0 was used to calculate the standardized incidence rate ratio (SIR) and absolute excess rate (AER). In addition, Cox regression models were used to estimate the hazard ratio (HR) of different age, race, sex, chemotherapy, and radiation and other factors for secondary tumors by R 4.2.1, and Kaplan-Meier method was used to plot the cumulative incidence. Results A total of 22 407 cases were included, and the person-years of follow-up were 142780.82. There was a total of 436 SPC cases, 32 of which developed multiple cancers. The median time of secondary cancers was 47.5 months. Patients with ALL had a higher risk of SPC than the general population (SIR=2.27; 95% , CI:2.07-2.50), and the most observed SPC was lymphatic and hematopoietic system, with an SIR of 6.96 (95% CI:5.94-8.11). The risk of SPC in ALL patients diagnosed in different time periods showed an upward trend, from 1.98 in 2000 to 2.38 in 2019. With the increase of age, the risk of SPC in ALL patients gradually decreased. Chemotherapy reduced the risk of SPC (HR=0.26; 95%CI: 0.19-0.36), while radiotherapy increased the risk of SPC by 59.60% (HR=1.57; 95% CI: 1.23-2.00). Conclusion In the future, chemotherapy is recommended for ALL patients to reduce radiation exposure during radiotherapy, and more attention should be paid to the health status of ALL patients within 1-5 years after their onset.
