Second Primary Malignancy after Acute Promyelocytic Leukemia: A Population-Based Study

Abstract

Acute promyelocytic leukemia (APL), is now highly curable with treatment approaches that include all-trans retinoic acid (ATRA). The high incidence of APL in the Hispanics suggests an association with genetic variants in this population. Information on second primary malignancies (SPMs) in patients with APL is limited. The Surveillance, Epidemiology, and End Results (SEER) database was used to interrogate whether the rate of SPMs in patients with APL was associated with ethnicity and/or ATRA treatment. Between 2000 and 2016, 116 cases of SPM were diagnosed among 4019 patients with APL. The mean age at diagnosis of primary APL was 53.9 years (±15.7 years), and the mean age at diagnosis of SPMs was 59.0 years (±14.5 years). Comparisons with 3774 APL survivors who did not develop SPMs revealed that age ≥40 years at diagnosis of APL (p < 0.001) and non-Hispanic white ethnicity (p = 0.025) were associated with SPMs in APL survivors. Salivary gland, liver, and soft tissue malignancies were significantly more common in patients with primary APL than in individuals with non-APL malignancies. A risk analysis comparing patients who had APL with patients who had non-APL AML suggests that SPMs after APL is associated with ATRA treatment. Therefore, patient follow-up after APL should focus on early diagnosis of SPMs.

Prognostic Relevance of DNMT3A, FLT3 and NPM1 Mutations in Syrian Acute Myeloid Leukemia Patients

“…In expansion, later information illustrate that DNMT3A mutations status has an effect on treatment choice; in one ponder, patients with DNMT3A mutations who were treated with high-dose daunorubicin compared to standard-dose treatment were appeared to have longer OS (Patel et al, 2012). However, results showed that the FLT3-ITD mutation has been identified as a marker of poor prognosis in AML, and that what most of studies agree, and the clinical outcomes of patients with FLT3-ITD-mutated AML combined with favorable cytogenetics was improved, when compared with those of patients with FLT3-ITD mono-mutated AML (Lenzi et al, 2020). Our findings showed that NPM1 mutation had a bad prognosis in AML patients and that in contrast with many studies, which they declared that OS were significantly longer for patients with NPM1 mutations.…”

A pharmacovigilance study of etoposide in the FDA adverse event reporting system (FAERS) database, what does the real world say?

“…At the neoplasm level, we also identified a number of ADEs with strong signal values. Second primary malignancy (SPM) (n = 43,) is defined as a second, distinct pathological diagnosis of the same or different origin as the first primary malignancy, and chemotherapy also increases the risk of secondary hematologic or solid malignancies (Lenzi et al, 2020;Geng et al, 2023). The mechanism of etoposide-induced second primary malignancy (SPM) can be attributed to two possible explanations.…”

Incidence, risk factors, and outcomes of second neoplasms in patients with acute promyelocytic leukemia: the PETHEMA-PALG experience

“…Previous multicentre study by the PETHEMA (Programa para el Tratamiento de Hemopatías Malignas) group characterized patients with s-MDS/AML developed after chemotherapy-based (AIDA) APL protocols. There are still few data concerning the incidence and outcomes of solid tumours after APL therapy [ 19 – 23 ].…”