Risk Factors for Melanoma Among Survivors of Non-Hodgkin Lymphoma.
J Clin Oncol
; 33(28): 3096-104, 2015 Oct 01.
Article
en En
| MEDLINE
| ID: mdl-26240221
ABSTRACT
PURPOSE:
Previous studies have reported that survivors of non-Hodgkin lymphoma (NHL) have an increased risk of developing cutaneous melanoma; however, risks associated with specific treatments and immune-related risk factors have not been quantified. PATIENTS ANDMETHODS:
We evaluated second melanoma risk among 44,870 1-year survivors of first primary NHL diagnosed at age 66 to 83 years from 1992 to 2009 and included in the Surveillance, Epidemiology, and End Results-Medicare database. Information on NHL treatments, autoimmune diseases, and infections was derived from Medicare claims.RESULTS:
A total of 202 second melanoma cases occurred among survivors of NHL, including 91 after chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) and 111 after other NHL subtypes (cumulative incidence by age 85 years CLL/SLL, 1.37%; other NHL subtypes, 0.78%). Melanoma risk after CLL/SLL was significantly increased among patients who received infused fludarabine-containing chemotherapy with or without rituximab (n=18 hazard ratio [HR], 1.92; 95% CI, 1.09 to 3.40; n=10 HR, 2.92; 95% CI, 1.42 to 6.01, respectively). Significantly elevated risks also were associated with T-cell activating autoimmune diseases diagnosed before CLL/SLL (n=36 HR, 2.27; 95% CI, 1.34 to 3.84) or after CLL/SLL (n=49 HR, 2.92; 95% CI, 1.66 to 5.12). In contrast, among patients with other NHL subtypes, melanoma risk was not associated with specific treatments or with T-cell/B-cell immune conditions. Generally, infections were not associated with melanoma risk, except for urinary tract infections (CLL/SLL), localized scleroderma, pneumonia, and gastrohepatic infections (other NHLs).CONCLUSION:
Our findings suggest immune perturbation may contribute to the development of melanoma after CLL/SLL. Increased vigilance is warranted among survivors of NHL to maximize opportunities for early detection of melanoma.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Neoplasias Cutáneas
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Linfoma no Hodgkin
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Neoplasias Primarias Secundarias
/
Sobrevivientes
/
Melanoma
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Evaluation_studies
/
Incidence_studies
/
Prognostic_studies
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Risk_factors_studies
/
Screening_studies
Límite:
Aged80
País/Región como asunto:
America do norte
Idioma:
En
Revista:
J Clin Oncol
Año:
2015
Tipo del documento:
Article