Marc Sorigue1, Roosa E I Prusila2,3, Jyrki Jauhiainen4, Santiago Mercadal5, Aleksi Postila2,3, Petteri Salmi2,3, Taru Tanhua2,3, Susanna Tikkanen2,3, Sakari Kakko3, Hanne Kuitunen2,3, Marjukka Pollari6, Ilja Nystrand7, Milla E L Kuusisto2,8, Kaija Vasala9, Esa Jantunen8,10,11, Eija Korkeila7, Peeter Karihtala2,3, Juan-Manuel Sancho1, Taina Turpeenniemi-Hujanen2,3, Outi Kuittinen3,11,12. 1. Department of Hematology, ICO-Hospital Germans Trias i Pujol, Institut de Recerca Josep Carreras, Barcelona, Spain. 2. Medical Research Center, Oulu University Hospital and Cancer and Translational Research Unit, University of Oulu, Oulu, Finland. 3. Department of Oncology and Radiotherapy, Oulu University Hospital, Oulu, Finland. 4. Department of Applied Physics, University of Eastern Finland, Kuopio, Finland. 5. Department of Hematology, ICO-Hospital Duran i Reynals, Hospitalet de Llobregat, Spain. 6. Department of Oncology, Tampere University Hospital, Tampere, Finland. 7. Department of Oncology, University of Turku and Turku University Hospital, Turku, Finland. 8. Siunsote - Hospital District of North Carelia, Joensuu, Finland. 9. Department of Oncology and Radiotherapy, Central Finland Central Hospital, Jyvaskyla, Finland. 10. Department of Medicine, Kuopio University Hospital, Kuopio, Finland. 11. Institute of Clinical Medicine, Faculty of Health Medicine, University of Eastern Finland, Kuopio, Finland. 12. Department of Oncology, Kuopio University Hospital, Kuopio, Finland.
Abstract
Introduction: Patients with follicular lymphoma (FL) have classically had a higher risk of solid cancers than the general population, but there is little data available in patients diagnosed and treated with modern day regimens.Material and methods: We conducted a retrospective multicenter study assessing the cumulative incidence of solid cancers other than nonmelanoma skin cancer in patients with FL between 1997 and 2016 and determined the standardized incidence ratio (SIR) to compare the incidence of solid cancers with that of the general population Results: Among 1002 FL patients with 7 years of median follow-up, we found 74 solid cancers (most common breast [n = 19], lung and colon [n = 9 each]). The cumulative incidence was 3.8% at 5 years (95%CI 2.6-5.2) from the time of diagnosis and 4.4% at 5 years (95%CI 3.1-5.9%) from the time of front-line treatment. Although a comparison of all front-line strategies did not reveal differences in the risk of solid cancers, patients treated with anthracycline-based regimens appeared to have a lower incidence than those treated with bendamustine-based strategies (2.8% vs. 6.9%). However, patients receiving the former regimen were younger than the latter. On multivariable analysis, older age was correlated with the incidence of solid cancer and bendamustine-based treatment was of borderline significance. SIR for any solid cancer was 1.22 (95%CI 0.91-1.64), indicating no increased risk of solid cancer in patients with FL over that of the general population. However, on subgroup analyses, female patients treated with bendamustine-based strategies appeared to have a greater risk (SIR 3.85 [95%CI 1.45-10.27])Discussion: The incidence of solid cancer in this cohort of patients with FL was low and not greater than in the general population. However, the risk may be greater in female patients treated with bendamustine.
Introduction: Patients with follicular lymphoma (FL) have classically had a higher risk of solid cancers than the general population, but there is little data available in patients diagnosed and treated with modern day regimens.Material and methods: We conducted a retrospective multicenter study assessing the cumulative incidence of solid cancers other than nonmelanoma skin cancer in patients with FL between 1997 and 2016 and determined the standardized incidence ratio (SIR) to compare the incidence of solid cancers with that of the general population Results: Among 1002 FL patients with 7 years of median follow-up, we found 74 solid cancers (most common breast [n = 19], lung and colon [n = 9 each]). The cumulative incidence was 3.8% at 5 years (95%CI 2.6-5.2) from the time of diagnosis and 4.4% at 5 years (95%CI 3.1-5.9%) from the time of front-line treatment. Although a comparison of all front-line strategies did not reveal differences in the risk of solid cancers, patients treated with anthracycline-based regimens appeared to have a lower incidence than those treated with bendamustine-based strategies (2.8% vs. 6.9%). However, patients receiving the former regimen were younger than the latter. On multivariable analysis, older age was correlated with the incidence of solid cancer and bendamustine-based treatment was of borderline significance. SIR for any solid cancer was 1.22 (95%CI 0.91-1.64), indicating no increased risk of solid cancer in patients with FL over that of the general population. However, on subgroup analyses, female patients treated with bendamustine-based strategies appeared to have a greater risk (SIR 3.85 [95%CI 1.45-10.27])Discussion: The incidence of solid cancer in this cohort of patients with FL was low and not greater than in the general population. However, the risk may be greater in female patients treated with bendamustine.
Authors: Aino Rajamäki; Mika Hujo; Reijo Sund; Roosa E I Prusila; Milla E L Kuusisto; Hanne Kuitunen; Esa Jantunen; Santiago Mercadal; Marc Sorigue; Juan-Manuel Sancho; Kaisa Sunela; Outi Kuittinen Journal: Cancer Date: 2022-04-13 Impact factor: 6.921