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Leukemic transformation and second cancers in 3649 patients with high-risk essential thrombocythemia in the EXELS study

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dc.contributor.author Birgegård, Gunnar
dc.contributor.author Folkvaljon, Folke
dc.contributor.author Garmo, Hans
dc.contributor.author Holmberg, Lars
dc.contributor.author Besses Raebel, Carles
dc.contributor.author Griesshammer, Martin
dc.contributor.author Gugliotta, Luigi
dc.contributor.author Wuh, Jingyang
dc.contributor.author Achenbach, Heinrich
dc.contributor.author Kiladjian, Jean-Jacques
dc.contributor.author Harrison, Claire N.
dc.date.accessioned 2019-06-12T07:28:21Z
dc.date.issued 2018
dc.identifier.citation Birgegård G, Folkvaljon F, Garmo H, Holmberg L, Besses C, Griesshammer M. et al. Leukemic transformation and second cancers in 3649 patients with high-risk essential thrombocythemia in the EXELS study. Leuk Res. 2018 Nov;74:105-109. DOI: 10.1016/j.leukres.2018.10.006
dc.identifier.issn 0145-2126
dc.identifier.uri http://hdl.handle.net/10230/41738
dc.description.abstract EXELS, a post-marketing observational study, is the largest prospective study of high-risk essential thrombocythemia (ET) patients, with an observation time of 5 years. EXELS found higher event rates of acute leukemia transformation in patients treated with hydroxycarbamide (HC). In the current analysis, we report age-adjusted rates of malignant transformation from 3460 EXELS patients exposed to HC, anagrelide (ANA), or both. At registration, 481 patients had ANA treatment without HC exposure, 2305 had HC without ANA exposure, and 674 had been exposed to both. Standard incidence ratios (SIRs) were calculated using data from the Cancer Incidence in Five Continents database to account for differences in age-, gender-, and country-specific background rates. SIRs for acute myelogenous leukemia (AML) were high in ET patients. SIRs for AML were high in HC-treated patients, but AML was rare in ANA-treated patients; no cases of AML were found in patients only treated with ANA. No statistically significant difference was seen between SIRs for ANA and HC treatment for AML or skin cancer. SIRs for other cancers were similar in the HC and ANA groups and close to 1, indicating little difference in risk. Although statistically inconclusive, this study strengthens concerns regarding possible leukemogenic risk with HC treatment. (NCT00202644).
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher Elsevier
dc.rights © Elsevier http://dx.doi.org/10.1016/j.leukres.2018.10.006
dc.title Leukemic transformation and second cancers in 3649 patients with high-risk essential thrombocythemia in the EXELS study
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.1016/j.leukres.2018.10.006
dc.subject.keyword Acute myelogenous leukemia
dc.subject.keyword Anagrelide
dc.subject.keyword Hydroxycarbamide
dc.subject.keyword Malignant transformation
dc.rights.accessRights info:eu-repo/semantics/embargoedAccess
dc.type.version info:eu-repo/semantics/acceptedVersion
dc.embargo.liftdate 2019-11-30
dc.date.embargoEnd info:eu-repo/date/embargoEnd/2019-11-30

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