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Second Primary Malignancies in CTCL Patients from 1992 to 2011: A SEER-Based, Population-Based Study Evaluating Time from CTCL Diagnosis, Age, Sex, Stage, and CD30+ Subtype

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Abstract

Background

Cutaneous T-cell lymphoma (CTCL) is a diverse group of extranodal non-Hodgkin lymphomas with malignant T lymphocytes localizing in the skin. CTCL can mainly be classified as mycosis fungoides, Sézary syndrome, or primary cutaneous CD30+ lymphoma. Patients with CTCL have an increased risk of developing second primary malignancies.

Objective

Our objective was to analyze the overall incidence of second primary malignancies in patients with CTCL by age, sex, stage, and the primary cutaneous CD30+ lymphoproliferative subtype of CTCL, as this group has usually been excluded from previous analyses.

Methods

We used the Surveillance, Epidemiology, and End Results (SEER) database to evaluate CTCL cases diagnosed between 1992 and 2011. We calculated the multiple primary standardized incidence ratio, comparing the observed incidence of second primary malignant neoplasms in the CTCL patient population versus the general population.

Results

CTCL is associated with an overall increased risk of cancers. This incidence is greatest within the first year of diagnosis. The risk of secondary Hodgkin disease is greatest in patients aged ≥60 years; the risk of secondary non-Hodgkin lymphoma is greatest in patients aged 20–39. Males demonstrated a significantly increased risk of developing Hodgkin lymphoma, while females showed a significantly increased risk of developing bronchopulmonary malignancy. Overall, secondary malignancy incidence was significantly elevated for stage I and IV CTCL. Patients with CD30+ CTCL had a significantly higher incidence of Hodgkin lymphoma, non-Hodgkin lymphoma, and urinary cancers than the general population.

Conclusion

Occult secondary malignancies, particularly lymphomas, should be considered in adult CTCL patients, including those with the CD30+ subtype.

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Authors and Affiliations

  1. Department of Dermatology, University of California Irvine Medical Center, Irvine, CA, USA

    Kyle T. Amber

  2. Department of Dermatology and Cutaneous Surgery, University of Miami, Miller School of Medicine, 10660 SW 75th Ave., Miami, FL, 33156, USA

    Romi Bloom & Keyvan Nouri

Authors
  1. Kyle T. Amber
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  2. Romi Bloom
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  3. Keyvan Nouri
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Corresponding author

Correspondence to Kyle T. Amber.

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Funding

No sources of funding were used to conduct this study or prepare the manuscript.

Conflict of interest

Kyle Amber, Romi Bloom, and Keyvan Nouri have no conflicts of interest to declare.

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Amber, K.T., Bloom, R. & Nouri, K. Second Primary Malignancies in CTCL Patients from 1992 to 2011: A SEER-Based, Population-Based Study Evaluating Time from CTCL Diagnosis, Age, Sex, Stage, and CD30+ Subtype. Am J Clin Dermatol 17, 71–77 (2016). https://doi.org/10.1007/s40257-015-0155-3

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  • DOI: https://doi.org/10.1007/s40257-015-0155-3

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