Contributions
Abstract: EP793
Type: E-Poster Presentation
Session title: Indolent and mantle-cell non-Hodgkin lymphoma - Clinical
Background
Hairy cell leukemia (HCL) is a rare lymphoproliferative disease with an excellent prognosis after therapy with purine analogs. Conflicting results have been published concerning second cancer in these patients: several studies have showed an increase of second cancer during long term follow-up.
Aims
The aim of the study is to report on the prevalence of second cancer among HCL patients treated with cladribine (2CDA) in first line in the last 30 years.
Methods
We retrospectively reviewed data of patients treated with 2CDA between March 1991 and May 2019 at 18 Italian Hematological centers. All patients consented to the study.
Results
Among 553 patients reported, only 513 were evaluable because treated with 2CDA alone. M/F ratio was 4.5 with a median age of 54 years (range 24-88) and ECOG was 0 in 85% of cases. Twenty-seven (5%) patients were diagnosed with a previous cancer: no relapse was reported during follow-up.
At a median follow-up of 6.96 years (range 3.81-12.47), 19 second neoplasms were reported in 18 patients (3.5%), a percentage that is lower than what reported in the literature. No cases of relapse of a previous cancer were reported. Six patients had a cancer of urinary tract (4 prostate, 2 kidney, 1 bladder), 5 had a GI cancer (1 esofagus, 1 stomach, 3 colorectal), 4 had an hematological neoplasm (2 multiple myeloma, 1 mantle cell lymphoma and 1 diffuse large B cell lymphoma), 2 had breast cancer and 1 had lung cancer. Moreover, precancerous lesions were reported in 1.2% of patients: 4 presented with skin cancer (3 basocellular carcinoma and 1 dysplastic nevus), 1 with pleomorfic parotid adenoma and 1 with colorectal displastic adenoma. No therapy-related myeloid neoplasms were observed.
Surgical therapy alone was a curative option in 8 patients, while chemotherapy alone was reported in 5 cases. A combination of surgery and chemotherapy +/- hormone therapy was used in 5 cases.
Median OS of the population was not reached; 95.7%, 92.8% and 82.3% of patients are expected to be alive at 5, 10 and 15 years, respectively. Among 45 patients which died during follow-up, 6 cases (1.2%) were due to second cancer.
We compared our data with that reported by the Italian registries of cancer for the same period of observation. Among the general population, the cumulative standard incidence of cancer was 704.4 casesx100.000 inhabitants for males and 484.7 casesx100.000 inhabitants for females. In our population, the cumulative standard incidence of cancer other than HCL was 543.3 x 100,000 (IC 95%: 283.6-803.1) for males and 492.6 x 100,000 (IC 95%: 0.0-1099.0) for females. No statistically significant differences were identified between the two cohorts.
Conclusion
While 2CDA is greatly effective in treating HCL, the occurrence of second cancer is rare. The cumulative incidence of second neoplasms in our population did not significantly differ from that reported among the Italian population.
Keyword(s): Cladribine, Hairy cell leukemia, Second malignancy
Abstract: EP793
Type: E-Poster Presentation
Session title: Indolent and mantle-cell non-Hodgkin lymphoma - Clinical
Background
Hairy cell leukemia (HCL) is a rare lymphoproliferative disease with an excellent prognosis after therapy with purine analogs. Conflicting results have been published concerning second cancer in these patients: several studies have showed an increase of second cancer during long term follow-up.
Aims
The aim of the study is to report on the prevalence of second cancer among HCL patients treated with cladribine (2CDA) in first line in the last 30 years.
Methods
We retrospectively reviewed data of patients treated with 2CDA between March 1991 and May 2019 at 18 Italian Hematological centers. All patients consented to the study.
Results
Among 553 patients reported, only 513 were evaluable because treated with 2CDA alone. M/F ratio was 4.5 with a median age of 54 years (range 24-88) and ECOG was 0 in 85% of cases. Twenty-seven (5%) patients were diagnosed with a previous cancer: no relapse was reported during follow-up.
At a median follow-up of 6.96 years (range 3.81-12.47), 19 second neoplasms were reported in 18 patients (3.5%), a percentage that is lower than what reported in the literature. No cases of relapse of a previous cancer were reported. Six patients had a cancer of urinary tract (4 prostate, 2 kidney, 1 bladder), 5 had a GI cancer (1 esofagus, 1 stomach, 3 colorectal), 4 had an hematological neoplasm (2 multiple myeloma, 1 mantle cell lymphoma and 1 diffuse large B cell lymphoma), 2 had breast cancer and 1 had lung cancer. Moreover, precancerous lesions were reported in 1.2% of patients: 4 presented with skin cancer (3 basocellular carcinoma and 1 dysplastic nevus), 1 with pleomorfic parotid adenoma and 1 with colorectal displastic adenoma. No therapy-related myeloid neoplasms were observed.
Surgical therapy alone was a curative option in 8 patients, while chemotherapy alone was reported in 5 cases. A combination of surgery and chemotherapy +/- hormone therapy was used in 5 cases.
Median OS of the population was not reached; 95.7%, 92.8% and 82.3% of patients are expected to be alive at 5, 10 and 15 years, respectively. Among 45 patients which died during follow-up, 6 cases (1.2%) were due to second cancer.
We compared our data with that reported by the Italian registries of cancer for the same period of observation. Among the general population, the cumulative standard incidence of cancer was 704.4 casesx100.000 inhabitants for males and 484.7 casesx100.000 inhabitants for females. In our population, the cumulative standard incidence of cancer other than HCL was 543.3 x 100,000 (IC 95%: 283.6-803.1) for males and 492.6 x 100,000 (IC 95%: 0.0-1099.0) for females. No statistically significant differences were identified between the two cohorts.
Conclusion
While 2CDA is greatly effective in treating HCL, the occurrence of second cancer is rare. The cumulative incidence of second neoplasms in our population did not significantly differ from that reported among the Italian population.
Keyword(s): Cladribine, Hairy cell leukemia, Second malignancy