Traslational Research Unit. CIBERER. IIS-A
Contributions
Type: Publication Only
Background
Follicular lymphoma (FL) account approximately one third of all non-Hodgkin lymphomas, it is know that primary affect males and white population; also is established that any patient diagnosed for a primary cancer have an increased risk to be diagnosed for a second primary neoplasm (SPN), respect to follicular lymphoma there are few reports about a 25% increased risk for all non-Hodgkin lymphomas not related with histologic subtype. Although is recognized that chemotherapy, radiotherapy and radioimmunotherapy (RIT) increased this risk; there are recent reports about the use of radioimmunotherapy with 90Y-Ibritumomab-Tiuxetan (90Y-IT) that show an increased risk for SPN. RIT is available in our center since 2005 and we have been accumulated a long experience. Considering this we analyze our data and compare the incidence of SPN in all patients with FL treated in our institution with different schedules including or not 90Y-IT.
Aims
To analyze the incidence of second primary neoplasm in FL patients diagnosed and treated in our center, searching for relationship with RIT
Methods
A chart review was carried using the registry of diagnosed patients, from the Department of Hematology, all consecutive patients diagnosed of Follicular lymphoma of any grade according to WHO since 2001 were included, a review of clinical records: demographic and clinical data, incidence of previous cancer and therapies, SPN (basocellular skin and in situ cervix carcinoma were excluded), number of chemotherapies, relapses, therapy with 90Y-IT, actual status and cause of dead were recorded.
Results
A total of 251 FL patients were registered, Male/female ratio: 107/144, mean age 59.9 years (15-86), Stage I: 7.2%, II: 11.0%, III: 24.1%, IV: 57.8%, FLIPI: Low-risk: 62.15%, Intermedium: 13.9%, High-risk: 10.3%. A 27.8% of patients receiving two or more chemotherapy schedules, 10,5% had underwent an auto-SCT. 100 patients (39.8%) received 90Y-IT (55 as a 2nd or 3rd line of therapy and 45 as a consolidation therapy). The mean follow-up for all patients is 108 months (median 49 m). Respect to incidence of neoplasms we found that 38 (15.1%) patients have a registry of at least 2 primary cancers, in 16 (42.1%) of them FL diagnosis were the second primary neoplasm. In the 22 patients who developed a SPN after FL diagnosis, 11 had been received two or more lines of therapies and 5 of them including RIT.
According to relationship with 90Y-IT, in 3 SPN were diagnosed before the use of RIT and in one at the same time of RIT, and in 8 patients the diagnosis of SPN occur after RIT at a mean time of 32.3 months. For all patients the SPN were recorded at a mean time of 24.5 months after FL diagnosis.
Summary
Even this work is a single institution reports, summarize relevant information outside clinical trials about the incidence of second primary neoplasm in one cohort of follicular lymphoma patients treated (100) or not (151) with 90Y-IT. In our experience 90Y-IT not increase significantly the risk of SPN. A more exhaustive analysis will be presented in case of acceptance.
Keyword(s): Follicular lymphoma, Radioimmunotherapy, Second malignancy
Session topic: Publication Only
Type: Publication Only
Background
Follicular lymphoma (FL) account approximately one third of all non-Hodgkin lymphomas, it is know that primary affect males and white population; also is established that any patient diagnosed for a primary cancer have an increased risk to be diagnosed for a second primary neoplasm (SPN), respect to follicular lymphoma there are few reports about a 25% increased risk for all non-Hodgkin lymphomas not related with histologic subtype. Although is recognized that chemotherapy, radiotherapy and radioimmunotherapy (RIT) increased this risk; there are recent reports about the use of radioimmunotherapy with 90Y-Ibritumomab-Tiuxetan (90Y-IT) that show an increased risk for SPN. RIT is available in our center since 2005 and we have been accumulated a long experience. Considering this we analyze our data and compare the incidence of SPN in all patients with FL treated in our institution with different schedules including or not 90Y-IT.
Aims
To analyze the incidence of second primary neoplasm in FL patients diagnosed and treated in our center, searching for relationship with RIT
Methods
A chart review was carried using the registry of diagnosed patients, from the Department of Hematology, all consecutive patients diagnosed of Follicular lymphoma of any grade according to WHO since 2001 were included, a review of clinical records: demographic and clinical data, incidence of previous cancer and therapies, SPN (basocellular skin and in situ cervix carcinoma were excluded), number of chemotherapies, relapses, therapy with 90Y-IT, actual status and cause of dead were recorded.
Results
A total of 251 FL patients were registered, Male/female ratio: 107/144, mean age 59.9 years (15-86), Stage I: 7.2%, II: 11.0%, III: 24.1%, IV: 57.8%, FLIPI: Low-risk: 62.15%, Intermedium: 13.9%, High-risk: 10.3%. A 27.8% of patients receiving two or more chemotherapy schedules, 10,5% had underwent an auto-SCT. 100 patients (39.8%) received 90Y-IT (55 as a 2nd or 3rd line of therapy and 45 as a consolidation therapy). The mean follow-up for all patients is 108 months (median 49 m). Respect to incidence of neoplasms we found that 38 (15.1%) patients have a registry of at least 2 primary cancers, in 16 (42.1%) of them FL diagnosis were the second primary neoplasm. In the 22 patients who developed a SPN after FL diagnosis, 11 had been received two or more lines of therapies and 5 of them including RIT.
According to relationship with 90Y-IT, in 3 SPN were diagnosed before the use of RIT and in one at the same time of RIT, and in 8 patients the diagnosis of SPN occur after RIT at a mean time of 32.3 months. For all patients the SPN were recorded at a mean time of 24.5 months after FL diagnosis.
Summary
Even this work is a single institution reports, summarize relevant information outside clinical trials about the incidence of second primary neoplasm in one cohort of follicular lymphoma patients treated (100) or not (151) with 90Y-IT. In our experience 90Y-IT not increase significantly the risk of SPN. A more exhaustive analysis will be presented in case of acceptance.
Keyword(s): Follicular lymphoma, Radioimmunotherapy, Second malignancy
Session topic: Publication Only