Second primary malignancies in acute myeloid leukemia.

Abstract

e20529 Background: Long-term survival rate in acute myeloid leukemia (AML) patients younger than 60 yrs is higher than 40% (Mayer RJ, et al N Engl J Med 2004). Development of second primary malignancy (SPM) in these patients is unknown. We analyzed the incidence of SPM in these AML patients using SEER database. Methods: We analyzed the Surveillance, Epidemiology, and End Results (SEER*Stat) database: Incidence - SEER 13 Regs Research Data, Nov 2011 Sub, Vintage 2009 Pops (1992-2009) using multiple primary standardized incidence ratio (MP-SIR) session. We evaluated SPM incidence rate among adult AML patients (age 20-59 yrs) during the period 1992 - 2009. We used SEER*Stat software for statistical analysis. Results: Total number of AML patients (age 20-59 yrs) reported during 1992-2009 period was 5,544. Median age at the time of diagnosis of SPM was 54.33 yrs ( 22.33-72.42 yrs). Median follow up was 8.13 yrs (2months – 17.8 yrs) and median latency period was 51 months ( 2-193months). The total number of all site SPM among AML patients reported during same time period was 100 with observed/expected (O/E) ratio of 1.03, (95% CI: 0.84-1.26), excess risk of 1.62 per 10,000 population. Ninety patients with AML developed SPM; 86 AML patients developed only 1 SPM and 7 patients developed 2 SPMs. The risk of oral cavity and pharyngeal cancer was significantly increased in AML patients with O/E: 3.99, p<0.05 (95% CI: 1.99-7.15), excess risk of 3.98 per 10,000 population. Similarly, cancer of urinary system was significantly increased in AML patients with O/E: 2.26, p<0.05 (95% CI: 1.23-3.79), excess risk of 3.77 per 10,000 population. Conclusions: This study showed significantly higher risk of second primary malignancies of oral cavity/pharyngeal cancer, and of urinary system in AML patients. [Table: see text]