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Risk of Secondary Primary Cancer Varies With Lymphoma Stage

Risk for SPMs differs over time for survivors of diffuse large B-cell lymphoma according to stage at diagnosis

FRIDAY, Oct. 18, 2019 (HealthDay News) — The risk of secondary primary malignancies (SPMs) varies based on stage of diffuse large B-cell lymphoma (DLBCL) at diagnosis, according to a study published online Sept. 11 in Cancer.

Ajay Major, M.D., from the University of Colorado School of Medicine in Aurora, and colleagues queried the Surveillance, Epidemiology, and End Results database for patients aged >18 years diagnosed with primary DLBCL from 1973 to 2010, and categorized by early-stage (ES: stage I to II) or advanced-stage (AS: stage III to IV) disease.

A total of 26,038 patients with DLBCL were identified: 14,724 with ES and 11,314 with AS disease. The researchers found that during a median follow-up of 13.3 years, 13 percent of patients developed SPM, with a higher but nonsignificantly increased risk in those with ES versus AS disease (14 versus 11.6 percent). Patients with ES disease had a higher risk of SPM than those with AS disease during the first five years after diagnosis, specifically colorectal, pancreas, breast, and prostate SPMs. Patients with AS disease had a higher risk of SPM than those with ES disease during the period from 10 to 15 years after diagnosis, specifically hematologic SPMs. Regardless of stage at diagnosis, development of SPM significantly increased the risk of death.

“It may be prudent for survivors to undergo site-specific surveillance screening based on the period of time since diagnosis,” the authors write.

One author disclosed financial ties to the pharmaceutical industry.

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