Patients with chronic myeloid leukemia (CML) and a history of prior malignancies appear to have the same outcomes as patients with no prior malignancies, according to a study published in Cancer.
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Some patients diagnosed with CML may have a history of prior cancers; however, there has been little research performed on how a history of malignancies may affect outcomes. Thus, researchers led by Jorge E Cortes, MD, University of Texas MD Anderson Cancer Center, Houston, conducted a study of 630 patients treated with a tyrosine kinase inhibitor (TKI) as initial therapy for CML in the chronic phase from July 2000 to January 2014.
A total of 626 patients included in the study had a known prior malignancy status. Forty-five patients (7%) had a malignancy other than nonmelanoma skin cancer while 17 patients (3%) had a history of nonmelanoma skin cancers alone. Patients with a prior malignancy were generally older than those who did not and the most common prior malignancies were nonmelanoma skin cancer (20 patients), breast cancer (11 patients), melanoma (7 patients), prostate cancer (6 patients), and colorectal cancer (5 patients).
Overall, event-free survival, transformation-free survival, and failure-free survival rates were similar in both cohorts. However, there was a decreased overall survival in the primary malignancies group, where the 5-year overall survival rate was 79%, compared with 100% in the nonmelanoma skin cancer group and 93% in the group with no prior malignancies.
In a multivariate analysis, advanced age and an elevated creatinine level were found to be associated with worse survival after a diagnosis of CML.
A total of 4 patients experienced a recurrence of their initial malignancy, three of which continued TKI therapy while receiving treatment for their other malignancy. Regimens were well tolerated in these patients.
“The results of the current study indicate that survivors of prior malignancies who develop CML as a second (or later) malignancy may have a similarly excellent outcome with TKI therapy as patients for whom CML is their first malignancy,” the authors concluded. “In fact, these data stress the importance of the control of other comorbid conditions after the diagnosis and treatment of CML.”
