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A population-based study of survival in patients with secondary myelodysplastic syndromes (MDS): impact of type and treatment of primary cancers

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Abstract

Objective

Myelodysplastic syndromes (MDS) following treatment with chemotherapy or irradiation are termed ‘secondary’ MDS. Clinical observations suggest a worse prognosis for secondary than for primary MDS, but differences in survival have not been studied in a general population sample.

Methods

We analyzed data from the Surveillance, Epidemiology, and End Results (SEER) program to describe survival in MDS patients according to previous cancer diagnosis. Our study included 3,938 MDS cases diagnosed in 2001–2004 and reported by registries which have participated in SEER since the 1970s.

Results

A previous cancer diagnosis (26% of MDS cases) was associated with 13% increased risk of death from any cause among MDS cases (hazard ratio [HR]=1.13, 95% confidence interval [CI]: 1.02–1.25). Radiation treatment for a previous cancer was associated with 52% increased risk of death (95% CI: 1.15–2.02). Shortened survival was most pronounced if the latency between the previous cancer and MDS was less than five years, including lung cancer diagnosed in the year preceding MDS (HR = 3.43, 95% CI: 1.93–6.10) and lymphohematopoietic cancer 1–5 years before MDS (HR = 2.11; 95% CI: 1.33–3.36).

Conclusions

Our results confirm a more severe prognosis for secondary MDS than for primary MDS, associated with certain types and treatments of previous cancer.

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Authors and Affiliations

  1. Public Health Sciences Division, Fred Hutchinson Cancer Research Center and Department of Epidemiology, University of Washington, 1100 Fairview Avenue N, M4-B874, Seattle, WA, 98109-1024, USA

    Anneclaire J. De Roos & Scott Davis

  2. Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    H. Joachim Deeg

Authors
  1. Anneclaire J. De Roos
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  2. H. Joachim Deeg
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  3. Scott Davis
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Correspondence to Anneclaire J. De Roos.

Additional information

Financial support: Dr. De Roos’ and Dr. Davis’ work was supported by a grant from the Surveillance, Epidemiology, and End Results (SEER) program of the National Cancer Institute (NO1-PC-55020-20), and Dr. Deeg’s work was supported by grants from the National Heart, Lung, and Blood Institute of the National Institutes of Health (HL36444 and HL082941).

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De Roos, A.J., Deeg, H.J. & Davis, S. A population-based study of survival in patients with secondary myelodysplastic syndromes (MDS): impact of type and treatment of primary cancers. Cancer Causes Control 18, 1199–1208 (2007). https://doi.org/10.1007/s10552-007-9060-2

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  • DOI: https://doi.org/10.1007/s10552-007-9060-2

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