Second primary malignancy after rituximab-containing immunochemotherapy for diffuse large B cell lymphoma

Abstract

Extended post-therapy long-term survival of patients with diffuse large B cell lymphoma (DLBCL) may also lead to an increase of late adverse events. We retrospectively investigated the frequency and clinical manifestation of second primary malignancy (SPM) after rituximab-containing immunochemotherapy in patients with DLBCL treated at seven institutes belonging to the Kyoto Clinical Hematology Study Group (KOTOSG) from the perspective of the existence of past or synchronous cancer history. In a median follow-up period of 899 days, 69 SPMs were observed in 58 of 809 patients. The most frequent SPM was gastric cancer, followed by lung cancer and colorectal cancer. The cumulative incidence of SPM increased steadily over time and was not significantly influenced by the presence or absence of past or synchronous cancer history. Our study suggests the need for careful attention to SPM in patients with DLBCL in daily practice.

Keywords:

• Second primary malignancy
• diffuse large B cell lymphoma
• past or synchronous cancer
• standardized incidence ratio
• risk factor
• epidemiology

Acknowledgments

The authors thank all the researchers of the KOTOSG for their scientific support. Past and current KOTOSG investigators who contributed to this study, other than the authors, are Shinsuke Mizutani, Yayoi Matsumura-Kimoto, Yoshimi Mizuno, Tomoko Takimoto-Shimomura, Saeko Kuwahara-Ota, Daichi Nishiyama, Yuto Fujibayashi, Takahiro Fujino, Reiko Isa, Junko Yamaguchi, Yuka Kawaji-Kanayama, Akio Ohnishi, Yoko Katsuragawa-Taminishi, Takahisa Nakamura, Yuri Kamitsuji, Eri Kawata, Teruaki Akaogi, Nana Sasaki, Yasuhiko Tsutsumi, Yukiko Komori, Haruya Okamoto, Akihiro Miyashita, Hiroaki Nagata, Ayako Muramatsu, Kodai Kuriyama, Muneo Ohshiro, Yoshiko Fujimoto-Hirakawa, Toshiki Iwai, Hikari Nishigaki, Koichi Hirakawa, Mihoko Yamashita-Yoshida, Mayumi Hatsuse, Satoshi Murakami, Saori Maegawa-Matsui, Daisuke Ide, Ryoichi Takahashi, Akira Okano, Sonoko Nakano-Akamatsu, Tatsuya Fujii, Yosuke Matsumoto, Mio Yamamoto-Sugitani, and Yusuke Yamane.

Disclosure statement

J.K. has received research funding from Celgene, Kyowa Kirin, Chugai Pharmaceutical, Ono Pharmaceutical, Sanofi, Eisai, Bristol-Myers Squibb, Sysmex, Astellas Pharma, Pfizer, Sumitomo Dainippon Pharma, Nippon Shinyaku, MSD, Fujimoto Pharmaceutical and Otsuka Pharmaceutical; has received honoraria from Janssen Pharmaceutical K.K., Celgene, Kyowa Kirin, Chugai Pharmaceutical, Ono Pharmaceutical, Sanofi, Eisai, Bristol-Myers Squibb, Astellas Pharma, Pfizer, Nippon Shinyaku, Sumitomo Dainippon Pharma, Fujimoto Pharmaceutical, Abbvie and Otsuka Pharmaceutical; and is a consultant for Janssen Pharmaceutical K.K., Celgene, Bristol-Myers Squibb, Sanofi and Abbvie. T.K. has received research funding from MSD; and has received honoraria from Chugai Pharmaceutical, Ono Pharmaceutical, Eisai, and Nippon Shinyaku. I.Y. has received honoraria from Chugai Pharmaceutical. T.T. has received research funding from Nippon Shinyaku.