Abstract 784P
Background
Leukemia survivors face an elevated risk of developing second primary malignancies (SPMs) due to previous immunosuppressive treatments like chemotherapy and the compromised immune system. Malignancies of infectious etiologies is a group of cancers that have infectious agents as one of their etiological factors, and their incidence among leukemia survivors has been insufficiently studied. This study investigated the long-term risk of SPMs of infectious etiologies among survivors of various types of leukemia.
Methods
Using SEER software, we conducted a comprehensive analysis of patients diagnosed with leukemia. Malignancies of infectious etiologies were coded using ICD-O-3 topography codes. The study assessed the standardized incidence ratio (SIR) for SPMs as observed/expected (O/E) ratios and the excess risk (ER) was per 10,000. Significance was achieved at 0.05.
Results
Among the survivors of leukemia, the risk of developing additional 2nd primary leukemias had an overall O/E of 4.03 (P<0.05, 95%CI: 3.84-4.24, ER=11.77). Meanwhile, liver tumors showed lesser risk with an O/E 0.81 (P<0.05, 95%CI: 0.69-0.94, ER=-0.41). The risk of oral cavity and pharyngeal tumors had an O/E of 1.54 (P<0.05, ER=1.69). The risk of anorectal tumors had an O/E of 1.42 (P<0.05, 95%CI: 1.09-1.82, ER=0.18). There was a significant risk for developing male genital system tumors in the 2-11 months interval (O/E of 1.18, P<0.05) with an O/E of 1.09 along 10+ years of follow up (P<0.05). The risk of urinary bladder tumors had an overall O/E of 1.44 (P<0.05 , ER=3.27). There was a significant increased risk of 2nd primary lymphomas with an overall O/E of 3.16 (P<0.05). The risk of myelomas had an overall O/E of 1.17 (P<0.05, 95%CI: 1.02-1.32, ER=0.34). The risk of Kaposi sarcomas tumors had an overall O/E of 2.51 (P<0.05, ER=0.11).
Conclusions
The findings highlight the long-term risk for various SPMs among leukemia survivors, with significant high risk for leukemias among all SPMs of infectious etiologies, and the least risk was liver tumors. These results emphasize the need for ongoing vigilance and tailored surveillance strategies for leukemia survivors to facilitate early detection and management of SPMs and prevention programs for the predisposing infectious agents.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.