Risk of developing chronic myeloid neoplasms in well-differentiated thyroid cancer patients treated with radioactive iodine

Exposure to ionizing radiation increases the risk of myelodysplastic syndromes (MDS) and myeloproliferative neoplasms (MPN), but such risks are not known in well-differentiated thyroid cancer (WDTC) patients treated with radioactive iodine (RAI). A total of 148 215 WDTC patients were identified from...

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Veröffentlicht in:Leukemia 2018-04, Vol.32 (4), p.952-959
Hauptverfasser: Molenaar, R J, Pleyer, C, Radivoyevitch, T, Sidana, S, Godley, A, Advani, A S, Gerds, A T, Carraway, H E, Kalaycio, M, Nazha, A, Adelstein, D J, Nasr, C, Angelini, D, Maciejewski, J P, Majhail, N, Sekeres, M A, Mukherjee, S
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container_issue 4
container_start_page 952
container_title Leukemia
container_volume 32
creator Molenaar, R J
Pleyer, C
Radivoyevitch, T
Sidana, S
Godley, A
Advani, A S
Gerds, A T
Carraway, H E
Kalaycio, M
Nazha, A
Adelstein, D J
Nasr, C
Angelini, D
Maciejewski, J P
Majhail, N
Sekeres, M A
Mukherjee, S
description Exposure to ionizing radiation increases the risk of myelodysplastic syndromes (MDS) and myeloproliferative neoplasms (MPN), but such risks are not known in well-differentiated thyroid cancer (WDTC) patients treated with radioactive iodine (RAI). A total of 148 215 WDTC patients were identified from Surveillance, Epidemiology and End Results registries between 1973 and 2014, of whom 54% underwent definitive thyroidectomy and 46% received adjuvant RAI. With a median follow-up of 6.6 years, 77 and 66 WDTC patients developed MDS and MPN, respectively. Excess absolute risks for MDS and MPN from RAI treatment when compared to background rates in the US population were 6.6 and 8.1 cases per 100 000 person-years, respectively. Compared to background population rates, relative risks of developing MDS (3.85 (95% confidence interval, 1.7–7.6); P =0.0005) and MPN (3.13 (1.1–6.8); P =0.012) were significantly elevated in the second and third year following adjuvant RAI therapy, but not after thyroidectomy alone. The increased risk was significantly associated with WDTC size ⩾2 cm or regional disease. Development of MDS was associated with shorter median overall survival in WDTC survivors (10.3 vs 22.5 years; P
doi_str_mv 10.1038/leu.2017.323
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subjects 631/67/1990/1673
631/67/1990/2331
631/67/2324
692/308/174
692/499
Cancer
Cancer Research
Care and treatment
Chronic myeloid leukemia
Complications and side effects
Confidence intervals
Critical Care Medicine
Epidemiology
Health aspects
Health risk assessment
Hematology
Intensive
Internal Medicine
Iodine
Iodine radioisotopes
Ionizing radiation
Latency
Medicine
Medicine & Public Health
Myelodysplastic syndrome
Neoplasms
Oncology
original-article
Patients
Prognosis
Radioiodine
Radiotherapy
Regional development
Risk assessment
Risk factors
Survival
Thyroid
Thyroid cancer
Thyroidectomy
Tumors
title Risk of developing chronic myeloid neoplasms in well-differentiated thyroid cancer patients treated with radioactive iodine
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