Associations between hematopoietic growth factors and risks of venous thromboembolism, stroke, ischemic heart disease and myelodysplastic syndrome

findings from a large population-based cohort of women with breast cancer

Xianglin L. Du, Yefei Zhang, Dale Sharon Hardy

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Purpose: To determine the risk of venous thromboembolism (VTE), stroke, ischemic heart disease, and myelodysplastic syndrome (MDS) in association with the receipt of colony-stimulating factors (CSFs) and/or erythropoiesis-stimulating agents (ESAs) in women with breast cancer. Methods: We studied 77,233 women with breast cancer aged ≥65 in 1992–2009 from the Surveillance, Epidemiology, and End Results-Medicare linked data with up to 19 years of follow-up. Results: Incidence of VTE increased from 9 cases in women receiving no chemotherapy and no CSFs/ESAs to 22.79 cases per 1,000 person-years in those receiving chemotherapy with CSFs and ESAs. Women with chemotherapy who received both CSFs and ESAs (adjusted hazard ratio and 95 % confidence interval 2.01, 1.80–2.25) or received ESAs without CSFs (2.03, 1.74–2.36) were twice as likely to develop VTE than those receiving no chemotherapy and no CSFs/ESAs, whereas those receiving CSF alone without ESA were 64 % more likely to have VTE (1.64, 1.45–1.85). Risk of MDS was significantly increased by fivefold in patients receiving ESA following chemotherapy. Conclusions: Receipts of CSFs and ESAs were significantly associated with an increased risk of VTE in women with breast cancer. Use of ESAs was significantly associated with substantially increased risks of MDS. These findings support those of previous studies.

Original languageEnglish (US)
Pages (from-to)695-707
Number of pages13
JournalCancer Causes and Control
Volume27
Issue number5
DOIs
StatePublished - May 1 2016

Fingerprint

Hematinics
Myelodysplastic Syndromes
Venous Thromboembolism
Colony-Stimulating Factors
Myocardial Ischemia
Intercellular Signaling Peptides and Proteins
Stroke
Breast Neoplasms
Population
Drug Therapy
Medicare
Epidemiology
Confidence Intervals

Keywords

  • Acute leukemia
  • Breast cancer
  • Hematopoietic growth factor
  • Ischemic heart disease
  • Stroke
  • Thromboembolism

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

@article{2b22606de39b4acf8649ddcbba910c2d,
title = "Associations between hematopoietic growth factors and risks of venous thromboembolism, stroke, ischemic heart disease and myelodysplastic syndrome: findings from a large population-based cohort of women with breast cancer",
abstract = "Purpose: To determine the risk of venous thromboembolism (VTE), stroke, ischemic heart disease, and myelodysplastic syndrome (MDS) in association with the receipt of colony-stimulating factors (CSFs) and/or erythropoiesis-stimulating agents (ESAs) in women with breast cancer. Methods: We studied 77,233 women with breast cancer aged ≥65 in 1992–2009 from the Surveillance, Epidemiology, and End Results-Medicare linked data with up to 19 years of follow-up. Results: Incidence of VTE increased from 9 cases in women receiving no chemotherapy and no CSFs/ESAs to 22.79 cases per 1,000 person-years in those receiving chemotherapy with CSFs and ESAs. Women with chemotherapy who received both CSFs and ESAs (adjusted hazard ratio and 95 {\%} confidence interval 2.01, 1.80–2.25) or received ESAs without CSFs (2.03, 1.74–2.36) were twice as likely to develop VTE than those receiving no chemotherapy and no CSFs/ESAs, whereas those receiving CSF alone without ESA were 64 {\%} more likely to have VTE (1.64, 1.45–1.85). Risk of MDS was significantly increased by fivefold in patients receiving ESA following chemotherapy. Conclusions: Receipts of CSFs and ESAs were significantly associated with an increased risk of VTE in women with breast cancer. Use of ESAs was significantly associated with substantially increased risks of MDS. These findings support those of previous studies.",
keywords = "Acute leukemia, Breast cancer, Hematopoietic growth factor, Ischemic heart disease, Stroke, Thromboembolism",
author = "Du, {Xianglin L.} and Yefei Zhang and Hardy, {Dale Sharon}",
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doi = "10.1007/s10552-016-0742-5",
language = "English (US)",
volume = "27",
pages = "695--707",
journal = "Cancer Causes and Control",
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T1 - Associations between hematopoietic growth factors and risks of venous thromboembolism, stroke, ischemic heart disease and myelodysplastic syndrome

T2 - findings from a large population-based cohort of women with breast cancer

AU - Du, Xianglin L.

AU - Zhang, Yefei

AU - Hardy, Dale Sharon

PY - 2016/5/1

Y1 - 2016/5/1

N2 - Purpose: To determine the risk of venous thromboembolism (VTE), stroke, ischemic heart disease, and myelodysplastic syndrome (MDS) in association with the receipt of colony-stimulating factors (CSFs) and/or erythropoiesis-stimulating agents (ESAs) in women with breast cancer. Methods: We studied 77,233 women with breast cancer aged ≥65 in 1992–2009 from the Surveillance, Epidemiology, and End Results-Medicare linked data with up to 19 years of follow-up. Results: Incidence of VTE increased from 9 cases in women receiving no chemotherapy and no CSFs/ESAs to 22.79 cases per 1,000 person-years in those receiving chemotherapy with CSFs and ESAs. Women with chemotherapy who received both CSFs and ESAs (adjusted hazard ratio and 95 % confidence interval 2.01, 1.80–2.25) or received ESAs without CSFs (2.03, 1.74–2.36) were twice as likely to develop VTE than those receiving no chemotherapy and no CSFs/ESAs, whereas those receiving CSF alone without ESA were 64 % more likely to have VTE (1.64, 1.45–1.85). Risk of MDS was significantly increased by fivefold in patients receiving ESA following chemotherapy. Conclusions: Receipts of CSFs and ESAs were significantly associated with an increased risk of VTE in women with breast cancer. Use of ESAs was significantly associated with substantially increased risks of MDS. These findings support those of previous studies.

AB - Purpose: To determine the risk of venous thromboembolism (VTE), stroke, ischemic heart disease, and myelodysplastic syndrome (MDS) in association with the receipt of colony-stimulating factors (CSFs) and/or erythropoiesis-stimulating agents (ESAs) in women with breast cancer. Methods: We studied 77,233 women with breast cancer aged ≥65 in 1992–2009 from the Surveillance, Epidemiology, and End Results-Medicare linked data with up to 19 years of follow-up. Results: Incidence of VTE increased from 9 cases in women receiving no chemotherapy and no CSFs/ESAs to 22.79 cases per 1,000 person-years in those receiving chemotherapy with CSFs and ESAs. Women with chemotherapy who received both CSFs and ESAs (adjusted hazard ratio and 95 % confidence interval 2.01, 1.80–2.25) or received ESAs without CSFs (2.03, 1.74–2.36) were twice as likely to develop VTE than those receiving no chemotherapy and no CSFs/ESAs, whereas those receiving CSF alone without ESA were 64 % more likely to have VTE (1.64, 1.45–1.85). Risk of MDS was significantly increased by fivefold in patients receiving ESA following chemotherapy. Conclusions: Receipts of CSFs and ESAs were significantly associated with an increased risk of VTE in women with breast cancer. Use of ESAs was significantly associated with substantially increased risks of MDS. These findings support those of previous studies.

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KW - Thromboembolism

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U2 - 10.1007/s10552-016-0742-5

DO - 10.1007/s10552-016-0742-5

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