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dc.contributor.authorChattopadhyay, Sen_US
dc.contributor.authorZheng, Gen_US
dc.contributor.authorSud, Aen_US
dc.contributor.authorYu, Hen_US
dc.contributor.authorSundquist, Ken_US
dc.contributor.authorSundquist, Jen_US
dc.contributor.authorFörsti, Aen_US
dc.contributor.authorHemminki, Aen_US
dc.contributor.authorHoulston, Ren_US
dc.contributor.authorHemminki, Ken_US
dc.coverage.spatialEnglanden_US
dc.date.accessioned2018-07-04T13:05:37Z
dc.date.issued2018-08en_US
dc.identifierhttps://www.ncbi.nlm.nih.gov/pubmed/30075833en_US
dc.identifierS2352-3026(18)30108-Xen_US
dc.identifier.citationLancet Haematol, 2018, 5 (8), pp. e368 - e377en_US
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/1975
dc.identifier.eissn2352-3026en_US
dc.identifier.doi10.1016/S2352-3026(18)30108-Xen_US
dc.description.abstractBACKGROUND: Although advances in the treatment of myeloid neoplasms have led to improved patient survival, this improvement has been accompanied by an increased risk of second primary cancer (ie, the risk of another cancer after myeloid neoplasia). We aimed to assess bi-directional associations between myeloid cancers and other cancers-ie, development of second primary cancer in patients who have previously had myeloid cancer, and risks of myeloid neoplasia in patients who have previously had another cancer-to provide insight into possible mechanisms beyond side-effects of treatment and shared risk factors. METHODS: Using the Swedish Family-Cancer Database, we identified 35 928 individuals with primary myeloid cancer, including myeloproliferative neoplasms, acute myeloid leukaemia, chronic myeloid leukaemia, and myelodysplastic syndrome diagnosed between 1958 and 2015. The Swedish Family-Cancer Database includes every individual registered as a resident in Sweden starting in 1932, with full parental history. The primary endpoint was the assessment of relative risks (RRs) for second primary cancer, which we performed using means of incidence rate ratios, regressed over a generalised Poisson model. FINDINGS: Between 1958 and 2015, overall relative risk of second primary cancers was significantly increased after acute myeloid leukaemia (RR 1·29, 95% CI 1·17-1·41), chronic myeloid leukaemia (1·52, 1·35-1·69), myelodysplastic syndrome (1·42, 1·26-1·59), and all myeloproliferative neoplasms (1·37, 1·30-1·43) relative to the incidence of these cancers as first primary cancer. With myeloid neoplasia as a second primary cancer, risks were significantly increased for acute myeloid leukaemia (1·57, 1·48-1·65), chronic myeloid leukaemia (1·26, 1·13-1·40), and myelodysplastic syndrome (1·54, 1·42-1·67) relative to the incidence of these myeloid neoplasms as first primary cancers. Relative risk of upper aerodigestive tract cancer, squamous cell skin cancer, and non-Hodgkin lymphoma as second primary cancers were increased after all four types of myeloid neoplasia relative to their incidence as first primary cancers. High risks of myelodysplastic syndrome and acute myeloid leukaemia as second primary cancers were found after haematological cancers (RRs between 5·08 and 10·04). INTERPRETATION: The relative risks of second primary cancer are important for the long-term management of patients with myeloid cancers. The bi-directional associations of myeloid cancers with many other cancers suggest a number of candidate mechanisms that might contribute to the development and aetiology of a second primary cancer. These mechanisms might include immune dysfunction or the effects of treatment, and these should be assessed in future investigations. FUNDING: Deutsche Krebshilfe, Jane and Aatos Erkko Foundation, Sigrid Juselius Foundation, Finnish Cancer Organizations, Swedish Research Council, ALF from Region Skåne, and Bloodwise.en_US
dc.format.extente368 - e377en_US
dc.languageengen_US
dc.language.isoengen_US
dc.subjectAdolescenten_US
dc.subjectAdulten_US
dc.subjectAgeden_US
dc.subjectBone Marrow Neoplasmsen_US
dc.subjectChilden_US
dc.subjectChild, Preschoolen_US
dc.subjectFemaleen_US
dc.subjectFollow-Up Studiesen_US
dc.subjectHumansen_US
dc.subjectIncidenceen_US
dc.subjectMaleen_US
dc.subjectMiddle Ageden_US
dc.subjectNeoplasms, Second Primaryen_US
dc.subjectRisk Factorsen_US
dc.subjectSwedenen_US
dc.subjectYoung Adulten_US
dc.titleRisk of second primary cancer following myeloid neoplasia and risk of myeloid neoplasia as second primary cancer: a nationwide, observational follow up study in Sweden.en_US
dc.typeJournal Article
dcterms.dateAccepted2018-06-28en_US
rioxxterms.versionofrecord10.1016/S2352-3026(18)30108-Xen_US
rioxxterms.licenseref.startdate2018-08en_US
rioxxterms.typeJournal Article/Reviewen_US
dc.relation.isPartOfLancet Haematolen_US
pubs.issue8en_US
pubs.notesNot knownen_US
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Genetics and Epidemiology
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Genetics and Epidemiology/Molecular & Population Genetics
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Molecular Pathology
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Molecular Pathology/Molecular & Population Genetics
pubs.publication-statusPublisheden_US
pubs.volume5en_US
pubs.embargo.termsNot knownen_US
icr.researchteamMolecular & Population Geneticsen_US
dc.contributor.icrauthorHoulston, Richarden_US
dc.contributor.icrauthorSud, Amiten_US


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