Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
RISK OF LEUKEMIA FOLLOWING TREATMENT FOR NON-HODGKINS-LYMPHOMA
Autore:
TRAVIS LB; CURTIS RE; STOVALL M; HOLOWATY EJ; VANLEEUWEN FE; GLIMELIUS B; LYNCH CF; HAGENBEEK A; LI CY; BANKS PM; GOSPODAROWICZ MK; ADAMI J; WACHOLDER S; INSKIP PD; TUCKER M; BOICE JD;
Indirizzi:
NCI,DIV CANC ETIOL,EPIDEMIOL & BIOSTAT PROGRAM,EXECUT PLAZA N,SUITE 408 BETHESDA MD 20892 UNIV TEXAS,MD ANDERSON CANC CTR HOUSTON TX 00000 ONTARIO CANC TREATMENT & RES FDN TORONTO ON CANADA NETHERLANDS CANC INST AMSTERDAM NETHERLANDS UNIV UPPSALA HOSP UPPSALA SWEDEN UNIV IOWA IOWA CITY IA 00000 DR DANIEL DEN HOED CANC CTR 3008 AE ROTTERDAM NETHERLANDS MAYO CLIN & MAYO FDN ROCHESTER MN 55905 UNIV TEXAS,HLTH SCI CTR SAN ANTONIO TX 00000 PRINCESS MARGARET HOSP TORONTO M4X 1K9 ON CANADA
Titolo Testata:
Journal of the National Cancer Institute
fascicolo: 19, volume: 86, anno: 1994,
pagine: 1450 - 1457
Fonte:
ISI
Lingua:
ENG
Soggetto:
ACUTE NONLYMPHOCYTIC LEUKEMIA; CHRONIC LYMPHOCYTIC-LEUKEMIA; ADVANCED BREAST-CANCER; THERAPY-RELATED LEUKEMIA; 2ND MALIGNANT NEOPLASMS; COMBINATION CHEMOTHERAPY; ALKYLATING-AGENTS; MYELODYSPLASTIC SYNDROMES; OVARIAN-CANCER; PHASE-II;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
56
Recensione:
Indirizzi per estratti:
Citazione:
L.B. Travis et al., "RISK OF LEUKEMIA FOLLOWING TREATMENT FOR NON-HODGKINS-LYMPHOMA", Journal of the National Cancer Institute, 86(19), 1994, pp. 1450-1457

Abstract

Background: There have been few evaluations of the risk of acute nonlymphocytic leukemia (ANLL) following therapy for non-Hodgkin's lymphoma (NHL). Further, the relationship between cumulative dose of cytotoxic drug, radiation dose to active bone marrow, and the risk of ANLL following NHL have not been well described. Purpose: Our purpose was to examine the risk of ANLL in relationship to all prior treatment for NHL. Methods: Within a cohort study of 11 386 2-year survivors of NHL, 35case patients with secondary ANLL were identified and matched to 140 controls with NHL who did not develop ANLL. The primary eligibility criteria for the cohort included a diagnosis of NHL as a first primary cancer from January 1, 1965, through December 31, 1989; age 18 through 70 years at the time of initial diagnosis; and survival for 2 or more years without the development of a second invasive primary malignancy. Detailed information on chemotherapeutic drugs and radiotherapy was collected for all patients. Standard conditional logistic regression programs were used to estimate the relative risk (RR) of ANLL associatedwith specific therapies by comparing the exposure histories of case patients with individually matched controls. Results: Significant excesses of ANLL followed therapy with either prednimustine (RR = 13.4; 95%confidence interval [CI] = 1.1-156; P trend for dose <.05) or regimens containing mechlorethamine and procarbazine (RR = 12.6; 95% CI = 2.0-79; P<.05). Elevated risks of leukemia following therapy with chlorambucil were restricted to patients given cumulative doses of 1300 mg ormore (RR = 6.5; 95% CI = 1.6-26; P<.05), Cyclophosphamide regimens were associated with a small, nonsignificant increased risk of ANLL (RR = 1.8; 95% CI = 0.7-4.9), with most patients receiving relatively low cumulative doses (<20 000 mg). Radiotherapy given at higher doses without alkylating agents was linked to a nonsignificant threefold risk ofANLL compared with lower dose radiation or no radiotherapy. Conclusions: Our results suggest that prednimustine may be a human carcinogen, with a positive dose-response gradient evident for ANLL risk. The low,nonsignificant risk of leukemia associated with cyclophosphamide was reassuring because this drug is commonly used today. Despite the excesses of ANLL associated with specific therapies, secondary leukemia remains a rare occurrence following NHL. Of 10 000 NHL patients treated for 6 months with selected regimens including low cumulative doses of cyclophosphamide and followed for 10 years, an excess of four leukemiasmight be expected.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 02/07/20 alle ore 22:31:48