Risk of Leukemia Associated With the First Course of Cancer Treatment: An Analysis of the Surveillance, Epidemiology, and End Results Program Experience

The risk of leukemia associated with the first course of cancer treatment was evaluated in over 440,000 patients diagnosed during 1973–80 (average follow-up = 1.91 yr) from the National Cancer Institute's Surveillance, Epidemiology, and End Results Program. Although the reporting of the first c...

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Bibliographic Details
Published in:JNCI : Journal of the National Cancer Institute 1984-03, Vol.72 (3), p.531-544
Main Authors: Curtis, Rochelle E., Hankey, Benjamin F., Myers, Max H., Young, John L.
Format: Article
Language:English
Subjects:
Antineoplastic Agents - adverse effects
Biological and medical sciences
Drug toxicity and drugs side effects treatment
Female
Follow-Up Studies
Hodgkin Disease - drug therapy
Hodgkin Disease - radiotherapy
Humans
Kidney Neoplasms - drug therapy
Leukemia - chemically induced
Leukemia, Radiation-Induced - etiology
Medical sciences
Multiple Myeloma - drug therapy
Neoplasms - drug therapy
Neoplasms - radiotherapy
Neoplasms - therapy
Ovarian Neoplasms - drug therapy
Ovarian Neoplasms - radiotherapy
Pharmacology. Drug treatments
Radiotherapy - adverse effects
Risk
Toxicity: blood
Uterine Neoplasms - radiotherapy
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Summary:The risk of leukemia associated with the first course of cancer treatment was evaluated in over 440,000 patients diagnosed during 1973–80 (average follow-up = 1.91 yr) from the National Cancer Institute's Surveillance, Epidemiology, and End Results Program. Although the reporting of the first course of therapy probably was incomplete, 34 acute nonlymphocytic leu-kemias (ANLL) developed compared with 7.6 expected among 70,674 patients known to receive initial chemotherapy [relative risk (RR)=4.5, 95% confidence interval (CI)=3.1–6.3]. Significant ANLL excesses were observed following chemotherapy for breast cancer (RR=8.1), ovarian cancer (RR=22.2), and multiple myeloma (RR=9.5). Patients initially treated with radiation (with no record of chemotherapy) also had a significantly increased ANLL risk; 45 leukemias occurred versus 17.9 expected (RR=2.5, 95% CI=1.8–3.4). In this group, excess ANLL were found following irradiation for uterine corpus cancer (RR=4.0). Kidney and renal pelvis cancer patients had a twofold leukemia risk (all types) that was unrelated to treatment (RR=2.2).
ISSN:0027-8874
1460-2105
DOI:10.1093/jnci/72.3.531