Chronic myeloid leukemia among patients with a history of prior malignancies: A tale of dual survivorship

Paul B. Koller, Hagop M. Kantarjian, Graciela M. Nogueras-Gonzalez, Elias Jabbour, Srdan Verstovsek, Gautam Borthakur, Zeev Estrov, William G. Wierda, Guillermo Garcia-Manero, Alessandra Ferrajoli, Farhad Ravandi, Susan M. O'Brien, Jorge E. Cortes

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Some patients with chronic myeloid leukemia (CML) have a history of previous malignancies. To the authors' knowledge, outcomes for CML diagnosed in these patients have not been well described. The current study was conducted to determine the outcome of patients with CML and a history of prior malignancies. METHODS: The current study included patients who were enrolled in clinical trials of tyrosine kinase inhibitors as initial therapy for CML in chronic phase from July 2000 to January 2014. RESULTS: Of the 630 patients with CML who were treated with frontline tyrosine kinase inhibitors, 626 had a known prior malignancy status. Of these, 45 patients (7%) had a prior malignancy other than nonmelanoma skin cancer whereas 17 patients (3%) had a history of nonmelanoma skin cancers alone. Characteristics of CML were similar between the patients with no prior malignancy, those with a prior malignancy, and those with nonmelanoma skin cancer. Patients with a prior malignancy were found to have an older median age compared with the other 2 groups. The most common prior malignancies were nonmelanoma skin cancer in 20 patients, breast cancer in 11 patients, melanoma in 7 patients, prostate cancer in 6 patients, and colorectal cancer in 5 patients. With regard to CML, the event-free survival, transformation-free survival, and failure-free survival rates were found to be similar between the groups. There was a statistically significantly decreased survival in the group with a prior malignancy versus the group with no prior malignancy versus the group with nonmelanoma skin cancer. In a multivariate analysis, advanced age and an elevated creatinine level were found to be associated with worse survival after a diagnosis of CML. CONCLUSIONS: Patients with CML with a history of prior malignancies appear to have the same excellent outcome as patients with no prior malignancies. In the few instances in which concomitant therapy for other malignancies was required during therapy with tyrosine kinase inhibitors, this was able to be accomplished without significant toxicity. Cancer 2017;123:609–616.

Original languageEnglish (US)
Pages (from-to)609-616
Number of pages8
JournalCancer
Volume123
Issue number4
DOIs
StatePublished - Feb 15 2017
Externally publishedYes

Fingerprint

Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Survival Rate
Neoplasms
Skin Neoplasms
Protein-Tyrosine Kinases
Survival
Leukemia, Myeloid, Chronic Phase
Disease-Free Survival
Colorectal Neoplasms
Melanoma
Creatinine
Prostatic Neoplasms

Keywords

  • chronic myeloid leukemia (CML)
  • second cancer
  • survivor
  • tyrosine kinase inhibitor

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Koller, P. B., Kantarjian, H. M., Nogueras-Gonzalez, G. M., Jabbour, E., Verstovsek, S., Borthakur, G., ... Cortes, J. E. (2017). Chronic myeloid leukemia among patients with a history of prior malignancies: A tale of dual survivorship. Cancer, 123(4), 609-616. https://doi.org/10.1002/cncr.30362

Chronic myeloid leukemia among patients with a history of prior malignancies : A tale of dual survivorship. / Koller, Paul B.; Kantarjian, Hagop M.; Nogueras-Gonzalez, Graciela M.; Jabbour, Elias; Verstovsek, Srdan; Borthakur, Gautam; Estrov, Zeev; Wierda, William G.; Garcia-Manero, Guillermo; Ferrajoli, Alessandra; Ravandi, Farhad; O'Brien, Susan M.; Cortes, Jorge E.

In: Cancer, Vol. 123, No. 4, 15.02.2017, p. 609-616.

Research output: Contribution to journalArticle

Koller, PB, Kantarjian, HM, Nogueras-Gonzalez, GM, Jabbour, E, Verstovsek, S, Borthakur, G, Estrov, Z, Wierda, WG, Garcia-Manero, G, Ferrajoli, A, Ravandi, F, O'Brien, SM & Cortes, JE 2017, 'Chronic myeloid leukemia among patients with a history of prior malignancies: A tale of dual survivorship', Cancer, vol. 123, no. 4, pp. 609-616. https://doi.org/10.1002/cncr.30362
Koller PB, Kantarjian HM, Nogueras-Gonzalez GM, Jabbour E, Verstovsek S, Borthakur G et al. Chronic myeloid leukemia among patients with a history of prior malignancies: A tale of dual survivorship. Cancer. 2017 Feb 15;123(4):609-616. https://doi.org/10.1002/cncr.30362
Koller, Paul B. ; Kantarjian, Hagop M. ; Nogueras-Gonzalez, Graciela M. ; Jabbour, Elias ; Verstovsek, Srdan ; Borthakur, Gautam ; Estrov, Zeev ; Wierda, William G. ; Garcia-Manero, Guillermo ; Ferrajoli, Alessandra ; Ravandi, Farhad ; O'Brien, Susan M. ; Cortes, Jorge E. / Chronic myeloid leukemia among patients with a history of prior malignancies : A tale of dual survivorship. In: Cancer. 2017 ; Vol. 123, No. 4. pp. 609-616.
@article{0b8aa8065054473a908453665ce56ad9,
title = "Chronic myeloid leukemia among patients with a history of prior malignancies: A tale of dual survivorship",
abstract = "BACKGROUND: Some patients with chronic myeloid leukemia (CML) have a history of previous malignancies. To the authors' knowledge, outcomes for CML diagnosed in these patients have not been well described. The current study was conducted to determine the outcome of patients with CML and a history of prior malignancies. METHODS: The current study included patients who were enrolled in clinical trials of tyrosine kinase inhibitors as initial therapy for CML in chronic phase from July 2000 to January 2014. RESULTS: Of the 630 patients with CML who were treated with frontline tyrosine kinase inhibitors, 626 had a known prior malignancy status. Of these, 45 patients (7{\%}) had a prior malignancy other than nonmelanoma skin cancer whereas 17 patients (3{\%}) had a history of nonmelanoma skin cancers alone. Characteristics of CML were similar between the patients with no prior malignancy, those with a prior malignancy, and those with nonmelanoma skin cancer. Patients with a prior malignancy were found to have an older median age compared with the other 2 groups. The most common prior malignancies were nonmelanoma skin cancer in 20 patients, breast cancer in 11 patients, melanoma in 7 patients, prostate cancer in 6 patients, and colorectal cancer in 5 patients. With regard to CML, the event-free survival, transformation-free survival, and failure-free survival rates were found to be similar between the groups. There was a statistically significantly decreased survival in the group with a prior malignancy versus the group with no prior malignancy versus the group with nonmelanoma skin cancer. In a multivariate analysis, advanced age and an elevated creatinine level were found to be associated with worse survival after a diagnosis of CML. CONCLUSIONS: Patients with CML with a history of prior malignancies appear to have the same excellent outcome as patients with no prior malignancies. In the few instances in which concomitant therapy for other malignancies was required during therapy with tyrosine kinase inhibitors, this was able to be accomplished without significant toxicity. Cancer 2017;123:609–616.",
keywords = "chronic myeloid leukemia (CML), second cancer, survivor, tyrosine kinase inhibitor",
author = "Koller, {Paul B.} and Kantarjian, {Hagop M.} and Nogueras-Gonzalez, {Graciela M.} and Elias Jabbour and Srdan Verstovsek and Gautam Borthakur and Zeev Estrov and Wierda, {William G.} and Guillermo Garcia-Manero and Alessandra Ferrajoli and Farhad Ravandi and O'Brien, {Susan M.} and Cortes, {Jorge E.}",
year = "2017",
month = "2",
day = "15",
doi = "10.1002/cncr.30362",
language = "English (US)",
volume = "123",
pages = "609--616",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",
number = "4",

}

TY - JOUR

T1 - Chronic myeloid leukemia among patients with a history of prior malignancies

T2 - A tale of dual survivorship

AU - Koller, Paul B.

AU - Kantarjian, Hagop M.

AU - Nogueras-Gonzalez, Graciela M.

AU - Jabbour, Elias

AU - Verstovsek, Srdan

AU - Borthakur, Gautam

AU - Estrov, Zeev

AU - Wierda, William G.

AU - Garcia-Manero, Guillermo

AU - Ferrajoli, Alessandra

AU - Ravandi, Farhad

AU - O'Brien, Susan M.

AU - Cortes, Jorge E.

PY - 2017/2/15

Y1 - 2017/2/15

N2 - BACKGROUND: Some patients with chronic myeloid leukemia (CML) have a history of previous malignancies. To the authors' knowledge, outcomes for CML diagnosed in these patients have not been well described. The current study was conducted to determine the outcome of patients with CML and a history of prior malignancies. METHODS: The current study included patients who were enrolled in clinical trials of tyrosine kinase inhibitors as initial therapy for CML in chronic phase from July 2000 to January 2014. RESULTS: Of the 630 patients with CML who were treated with frontline tyrosine kinase inhibitors, 626 had a known prior malignancy status. Of these, 45 patients (7%) had a prior malignancy other than nonmelanoma skin cancer whereas 17 patients (3%) had a history of nonmelanoma skin cancers alone. Characteristics of CML were similar between the patients with no prior malignancy, those with a prior malignancy, and those with nonmelanoma skin cancer. Patients with a prior malignancy were found to have an older median age compared with the other 2 groups. The most common prior malignancies were nonmelanoma skin cancer in 20 patients, breast cancer in 11 patients, melanoma in 7 patients, prostate cancer in 6 patients, and colorectal cancer in 5 patients. With regard to CML, the event-free survival, transformation-free survival, and failure-free survival rates were found to be similar between the groups. There was a statistically significantly decreased survival in the group with a prior malignancy versus the group with no prior malignancy versus the group with nonmelanoma skin cancer. In a multivariate analysis, advanced age and an elevated creatinine level were found to be associated with worse survival after a diagnosis of CML. CONCLUSIONS: Patients with CML with a history of prior malignancies appear to have the same excellent outcome as patients with no prior malignancies. In the few instances in which concomitant therapy for other malignancies was required during therapy with tyrosine kinase inhibitors, this was able to be accomplished without significant toxicity. Cancer 2017;123:609–616.

AB - BACKGROUND: Some patients with chronic myeloid leukemia (CML) have a history of previous malignancies. To the authors' knowledge, outcomes for CML diagnosed in these patients have not been well described. The current study was conducted to determine the outcome of patients with CML and a history of prior malignancies. METHODS: The current study included patients who were enrolled in clinical trials of tyrosine kinase inhibitors as initial therapy for CML in chronic phase from July 2000 to January 2014. RESULTS: Of the 630 patients with CML who were treated with frontline tyrosine kinase inhibitors, 626 had a known prior malignancy status. Of these, 45 patients (7%) had a prior malignancy other than nonmelanoma skin cancer whereas 17 patients (3%) had a history of nonmelanoma skin cancers alone. Characteristics of CML were similar between the patients with no prior malignancy, those with a prior malignancy, and those with nonmelanoma skin cancer. Patients with a prior malignancy were found to have an older median age compared with the other 2 groups. The most common prior malignancies were nonmelanoma skin cancer in 20 patients, breast cancer in 11 patients, melanoma in 7 patients, prostate cancer in 6 patients, and colorectal cancer in 5 patients. With regard to CML, the event-free survival, transformation-free survival, and failure-free survival rates were found to be similar between the groups. There was a statistically significantly decreased survival in the group with a prior malignancy versus the group with no prior malignancy versus the group with nonmelanoma skin cancer. In a multivariate analysis, advanced age and an elevated creatinine level were found to be associated with worse survival after a diagnosis of CML. CONCLUSIONS: Patients with CML with a history of prior malignancies appear to have the same excellent outcome as patients with no prior malignancies. In the few instances in which concomitant therapy for other malignancies was required during therapy with tyrosine kinase inhibitors, this was able to be accomplished without significant toxicity. Cancer 2017;123:609–616.

KW - chronic myeloid leukemia (CML)

KW - second cancer

KW - survivor

KW - tyrosine kinase inhibitor

UR - http://www.scopus.com/inward/record.url?scp=85011649896&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85011649896&partnerID=8YFLogxK

U2 - 10.1002/cncr.30362

DO - 10.1002/cncr.30362

M3 - Article

C2 - 27763690

AN - SCOPUS:85011649896

VL - 123

SP - 609

EP - 616

JO - Cancer

JF - Cancer

SN - 0008-543X

IS - 4

ER -