Risk of therapy-related hematopoietic neoplasms among adult 1-year survivors of first primary neoplasms treated with initial chemotherapy (with or without radiotherapy) and diagnosed between 2000 and 2017 (followed through 2018), SEER-17
| First primary neoplasm . | Subsequent therapy-related hematologic neoplasm . | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| t-MDS/AML . | t-CML . | t-cMPNs . | t-CMML . | tr-ALL∗ . | ||||||||||||||||
| Solid tumors | ||||||||||||||||||||
| Median time to t-HN (y) | 3.7 | 4.8 | 5.6 | 4.1 | 4.7 | |||||||||||||||
| Lymphoid neoplasms | ||||||||||||||||||||
| Median time to t-HN (y) | 4.2 | 5.0 | 5.6 | 2.9 | 5.0 | |||||||||||||||
| Obs | % | SIR | 95%CI | Obs | % | SIR | 95%CI | Obs | % | SIR | 95%CI | Obs | % | SIR | 95%CI | Obs | % | SIR | 95%CI | |
| All solid tumors | 2616 | 63.6 | 2.76 | 2.65-2.86 | 175 | 77.4 | 1.43 | 1.23-1.66 | 234 | 82.7 | 0.72 | 0.63-0.81 | 64 | 57.7 | 1.24 | 0.96-1.58 | 144 | 62.1 | 2.43 | 2.05-2.86 |
| Oral cavity and pharynx | 105 | 2.6 | 2.22 | 1.81-2.68 | 11 | 4.9 | 1.72 | 0.86-3.07 | 16 | 5.7 | 1.05 | 0.60-1.70 | <3 | ∼ | ∼ | ∼ | 5 | 2.2 | 1.71 | 0.56-4.00 |
| Stomach | 48 | 1.2 | 2.62 | 1.93-3.48 | 3 | 1.3 | 1.50 | 0.31-4.38 | <3 | ∼ | ∼ | ∼ | <3 | ∼ | ∼ | ∼ | <3 | ∼ | ∼ | ∼ |
| Colon, excluding rectum | 123 | 3.0 | 1.03 | 0.86-1.23 | 20 | 8.8 | 1.52 | 0.93-2.35 | 35 | 12.4 | 0.99 | 0.69-1.38 | 8 | 7.2 | 1.13 | 0.49-2.22 | 7 | 3.0 | 1.20 | 0.48-2.48 |
| Rectum | 93 | 2.3 | 1.37 | 1.11-1.68 | 9 | 4.0 | 1.15 | 0.53-2.18 | 5 | 1.8 | 0.25 | 0.08-0.58 | <3 | ∼ | ∼ | ∼ | 10 | 4.3 | 2.84 | 1.36-5.22 |
| Lung/bronchus | 360 | 8.8 | 4.11 | 3.70-4.56 | 14 | 6.2 | 1.47 | 0.80-2.46 | 20 | 7.1 | 0.76 | 0.47-1.18 | 10 | 9.0 | 1.91 | 0.91-3.50 | 7 | 3.0 | 1.67 | 0.67-3.44 |
| Breast | 964 | 23.4 | 3.10 | 2.91-3.30 | 71 | 31.4 | 1.50 | 1.17-1.90 | 89 | 31.4 | 0.68 | 0.55-0.84 | 22 | 19.8 | 1.64 | 1.02-2.48 | 74 | 31.9 | 2.98 | 2.34-3.74 |
| Cervix uteri | 43 | 1.0 | 3.81 | 2.76-5.14 | <3 | ∼ | ∼ | ∼ | 6 | 2.1 | 1.24 | 0.45-2.69 | <3 | ∼ | ∼ | ∼ | 3 | 1.3 | 2.88 | 0.59-8.42 |
| Corpus uteri | 88 | 2.1 | 4.67 | 3.75-5.76 | 3 | 1.3 | 1.27 | 0.26-3.71 | 5 | 1.8 | 0.66 | 0.22-1.55 | <3 | ∼ | ∼ | ∼ | 5 | 2.2 | 4.25 | 1.38-9.92 |
| Ovary | 189 | 4.6 | 6.14 | 5.30-7.09 | 4 | 1.8 | 1.00 | 0.27-2.55 | 8 | 2.8 | 0.66 | 0.29-1.31 | <3 | ∼ | ∼ | ∼ | 5 | 2.2 | 2.39 | 0.78-5.58 |
| Urinary bladder | 125 | 3.0 | 1.37 | 1.14-1.63 | 10 | 4.4 | 1.19 | 0.57-2.18 | 22 | 7.8 | 0.98 | 0.62-1.49 | 9 | 8.1 | 1.47 | 0.67-2.80 | 4 | 1.7 | 1.15 | 0.31-2.95 |
| Lymphoid neoplasms | 1496 | 36.4 | 6.40 | 6.08-6.74 | 51 | 22.6 | 1.82 | 1.36-2.40 | 49 | 17.3 | 0.69 | 0.51-0.91 | 47 | 42.3 | 3.36 | 2.47-4.47 | 88 | 37.9 | 6.79 | 5.45-8.37 |
| Hodgkin lymphoma | 101 | 2.5 | 6.89 | 5.61-8.37 | 4 | 1.8 | 1.33 | 0.36-3.41 | 6 | 2.1 | 1.06 | 0.39-2.30 | 3 | 2.7 | 4.11 | 0.85-12.02 | 6 | 2.6 | 3.23 | 1.19-7.04 |
| NHL, excluding PCN | 1165 | 28.3 | 6.64 | 6.26-7.03 | 41 | 18.1 | 2.05 | 1.47-2.78 | 40 | 14.1 | 0.76 | 0.55-1.04 | 37 | 33.3 | 3.49 | 2.46-4.81 | 47 | 20.3 | 5.24 | 3.85-6.97 |
| DLBCL | 365 | 8.9 | 5.26 | 4.74-5.83 | 20 | 8.8 | 2.56 | 1.56-3.95 | 12 | 4.2 | 0.58 | 0.30-1.02 | 12 | 10.8 | 2.87 | 1.48-5.01 | 15 | 6.5 | 4.14 | 2.32-6.83 |
| Follicular lymphoma | 241 | 5.9 | 6.68 | 5.87-7.58 | 8 | 3.5 | 1.89 | 0.82-3.73 | 10 | 3.5 | 0.89 | 0.43-1.63 | 3 | 2.7 | 1.40 | 0.29-4.10 | 10 | 4.3 | 5.11 | 2.45-9.39 |
| PCN | 213 | 5.2 | 5.40 | 4.70-6.18 | 5 | 2.2 | 1.11 | 0.36-2.59 | 3 | 1.1 | 0.25 | 0.05-0.74 | 7 | 6.3 | 2.93 | 1.18-6.03 | 35 | 15.1 | 18.09 | 12.60-25.15 |
| First primary neoplasm . | Subsequent therapy-related hematologic neoplasm . | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| t-MDS/AML . | t-CML . | t-cMPNs . | t-CMML . | tr-ALL∗ . | ||||||||||||||||
| Solid tumors | ||||||||||||||||||||
| Median time to t-HN (y) | 3.7 | 4.8 | 5.6 | 4.1 | 4.7 | |||||||||||||||
| Lymphoid neoplasms | ||||||||||||||||||||
| Median time to t-HN (y) | 4.2 | 5.0 | 5.6 | 2.9 | 5.0 | |||||||||||||||
| Obs | % | SIR | 95%CI | Obs | % | SIR | 95%CI | Obs | % | SIR | 95%CI | Obs | % | SIR | 95%CI | Obs | % | SIR | 95%CI | |
| All solid tumors | 2616 | 63.6 | 2.76 | 2.65-2.86 | 175 | 77.4 | 1.43 | 1.23-1.66 | 234 | 82.7 | 0.72 | 0.63-0.81 | 64 | 57.7 | 1.24 | 0.96-1.58 | 144 | 62.1 | 2.43 | 2.05-2.86 |
| Oral cavity and pharynx | 105 | 2.6 | 2.22 | 1.81-2.68 | 11 | 4.9 | 1.72 | 0.86-3.07 | 16 | 5.7 | 1.05 | 0.60-1.70 | <3 | ∼ | ∼ | ∼ | 5 | 2.2 | 1.71 | 0.56-4.00 |
| Stomach | 48 | 1.2 | 2.62 | 1.93-3.48 | 3 | 1.3 | 1.50 | 0.31-4.38 | <3 | ∼ | ∼ | ∼ | <3 | ∼ | ∼ | ∼ | <3 | ∼ | ∼ | ∼ |
| Colon, excluding rectum | 123 | 3.0 | 1.03 | 0.86-1.23 | 20 | 8.8 | 1.52 | 0.93-2.35 | 35 | 12.4 | 0.99 | 0.69-1.38 | 8 | 7.2 | 1.13 | 0.49-2.22 | 7 | 3.0 | 1.20 | 0.48-2.48 |
| Rectum | 93 | 2.3 | 1.37 | 1.11-1.68 | 9 | 4.0 | 1.15 | 0.53-2.18 | 5 | 1.8 | 0.25 | 0.08-0.58 | <3 | ∼ | ∼ | ∼ | 10 | 4.3 | 2.84 | 1.36-5.22 |
| Lung/bronchus | 360 | 8.8 | 4.11 | 3.70-4.56 | 14 | 6.2 | 1.47 | 0.80-2.46 | 20 | 7.1 | 0.76 | 0.47-1.18 | 10 | 9.0 | 1.91 | 0.91-3.50 | 7 | 3.0 | 1.67 | 0.67-3.44 |
| Breast | 964 | 23.4 | 3.10 | 2.91-3.30 | 71 | 31.4 | 1.50 | 1.17-1.90 | 89 | 31.4 | 0.68 | 0.55-0.84 | 22 | 19.8 | 1.64 | 1.02-2.48 | 74 | 31.9 | 2.98 | 2.34-3.74 |
| Cervix uteri | 43 | 1.0 | 3.81 | 2.76-5.14 | <3 | ∼ | ∼ | ∼ | 6 | 2.1 | 1.24 | 0.45-2.69 | <3 | ∼ | ∼ | ∼ | 3 | 1.3 | 2.88 | 0.59-8.42 |
| Corpus uteri | 88 | 2.1 | 4.67 | 3.75-5.76 | 3 | 1.3 | 1.27 | 0.26-3.71 | 5 | 1.8 | 0.66 | 0.22-1.55 | <3 | ∼ | ∼ | ∼ | 5 | 2.2 | 4.25 | 1.38-9.92 |
| Ovary | 189 | 4.6 | 6.14 | 5.30-7.09 | 4 | 1.8 | 1.00 | 0.27-2.55 | 8 | 2.8 | 0.66 | 0.29-1.31 | <3 | ∼ | ∼ | ∼ | 5 | 2.2 | 2.39 | 0.78-5.58 |
| Urinary bladder | 125 | 3.0 | 1.37 | 1.14-1.63 | 10 | 4.4 | 1.19 | 0.57-2.18 | 22 | 7.8 | 0.98 | 0.62-1.49 | 9 | 8.1 | 1.47 | 0.67-2.80 | 4 | 1.7 | 1.15 | 0.31-2.95 |
| Lymphoid neoplasms | 1496 | 36.4 | 6.40 | 6.08-6.74 | 51 | 22.6 | 1.82 | 1.36-2.40 | 49 | 17.3 | 0.69 | 0.51-0.91 | 47 | 42.3 | 3.36 | 2.47-4.47 | 88 | 37.9 | 6.79 | 5.45-8.37 |
| Hodgkin lymphoma | 101 | 2.5 | 6.89 | 5.61-8.37 | 4 | 1.8 | 1.33 | 0.36-3.41 | 6 | 2.1 | 1.06 | 0.39-2.30 | 3 | 2.7 | 4.11 | 0.85-12.02 | 6 | 2.6 | 3.23 | 1.19-7.04 |
| NHL, excluding PCN | 1165 | 28.3 | 6.64 | 6.26-7.03 | 41 | 18.1 | 2.05 | 1.47-2.78 | 40 | 14.1 | 0.76 | 0.55-1.04 | 37 | 33.3 | 3.49 | 2.46-4.81 | 47 | 20.3 | 5.24 | 3.85-6.97 |
| DLBCL | 365 | 8.9 | 5.26 | 4.74-5.83 | 20 | 8.8 | 2.56 | 1.56-3.95 | 12 | 4.2 | 0.58 | 0.30-1.02 | 12 | 10.8 | 2.87 | 1.48-5.01 | 15 | 6.5 | 4.14 | 2.32-6.83 |
| Follicular lymphoma | 241 | 5.9 | 6.68 | 5.87-7.58 | 8 | 3.5 | 1.89 | 0.82-3.73 | 10 | 3.5 | 0.89 | 0.43-1.63 | 3 | 2.7 | 1.40 | 0.29-4.10 | 10 | 4.3 | 5.11 | 2.45-9.39 |
| PCN | 213 | 5.2 | 5.40 | 4.70-6.18 | 5 | 2.2 | 1.11 | 0.36-2.59 | 3 | 1.1 | 0.25 | 0.05-0.74 | 7 | 6.3 | 2.93 | 1.18-6.03 | 35 | 15.1 | 18.09 | 12.60-25.15 |
SEER-17 includes the population-based cancer registry coverage of the areas of Atlanta, Detroit, Seattle-Puget Sound; the states of Connecticut, Hawaii, Iowa, New Mexico, California (San Francisco-Oakland, Los Angeles, San Jose-Monterey, Greater California), Georgia (Rural Georgia, Greater Georgia), Utah, Kentucky, Louisiana, and New Jersey. The table is limited to first primary sites with at least 20,000 patients who are at risk. Data for outcomes associated with <3 cases are suppressed to protect patient confidentiality. First primary pancreas and brain cancers were omitted from the table because there were fewer than 3 cases of t-CML, t-cMPN, t-CMML, and tr-ALL.
DLBCL, diffuse large B-cell lymphoma; ICD-O-3, International Classification of Diseases for Oncology, third edition; Obs, observed; NHL, non-Hodgkin lymphoma; PCN, plasma cell neoplasms; t- or tr-, therapy-related; ∼, value suppressed because the case count was <3.
For analyses of tr-ALL, all ICD-O-3 codes included in the ALL category (as specified in supplemental Table 1) and all cases of blastic plasmacytoid dendritic cell neoplasm (ICD-O-3 code 9727/3) were excluded from the first primary lymphoid neoplasms category and the respective subcategories.