Evaluating the risks of developing secondary cancers in patients with chronic myeloproliferative neoplasms

Evaluating the risks of developing

secondary cancers in patients with

chronic myeloproliferative neoplasms:

A report of 42 years findings of a long

term project from 1957 to 1999.

Kingsley O. D.E.C., Kingsley O. K, Smith S M and Burke E.W

London Medical Academy Research Consortium, London, England, United Kingdom

Abstract

Background:

The burden of chronic myeloproliferative neoplasms (MPNs) includes significant quality of life impairment from chronic symptoms, such as fatigue, night sweats, and bone pain, which can lead to disability and decreased productivity. The disease also carries a risk of complications like thrombosis and leukemic transformation. Financially, the burden is high, with some patients requiring long-term disability leave and potentially a lower salary upon return to work. 

Aims:

To evaluate the risk of patients developing new haematological and nonhaematological malignancies after the diagnosis of essential thrombocythemia (EV), polycythemia vera (PV), chronic myeloid leukaemia (CML) or other types of myeloproliferative neoplasms in an international context.

Method:

A large international population-based cohort clinical research design approach was used in carrying out this study. Nine population-based international and nationwide in the various regions registries of the AHCP sponsored Medical Centres Registry of Patients, covering all the participating three international regions’ medical and community health centres, including the AHCP Medical Services Cancer Registries and Databases were used in collecting data for the study.

Results

The overall results showed that ET, PV, CML or other types of CMPNs patients were at increased risk of developing both new hematological and nonhaematological cancers and tumors. The findings also indicated that the standardised incidence ratio for developing a nonhaematological cancer among the patients we studied was 1.4 (95% confidence interval): 1.2-1.5 for patients with ET, 1.6 (95% confidence interval) for patients with PV, and 1.7 (95% confidence interval): 1.4-2.4) for patients with CML.

Conclusion

In this large population-based study of 47721 patients, we found a significantly increased risk of second non-haematological and haematological malignancies. Therefore, patients with chronic myeloproliferative neoplasms are at increased risk of developing a new malignant disease.

Keywords: Myeloproliferative Neopasm, disorders, ET, PV, CML, treatment, secondary cancers.

Paper Published in the Royal College of General Practitioners, North and West London Faculty Magazine, Volume 1, Number 8, 1999. This publication is available at the British Library, Legal Deposit Office