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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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 |
format | Article |
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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
<0.001). These data suggest that RAI treatment for WDTC is associated with increased risk of MDS with short latency and poor survival.</description><identifier>ISSN: 0887-6924</identifier><identifier>EISSN: 1476-5551</identifier><identifier>DOI: 10.1038/leu.2017.323</identifier><identifier>PMID: 29104287</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>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</subject><ispartof>Leukemia, 2018-04, Vol.32 (4), p.952-959</ispartof><rights>Macmillan Publishers Limited, part of Springer Nature 2018</rights><rights>COPYRIGHT 2018 Nature Publishing Group</rights><rights>Copyright Nature Publishing Group Apr 2018</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c455t-422f539610444b1cd479c59764a8df1f919d67070343b6058ba591412aaa07003</citedby><cites>FETCH-LOGICAL-c455t-422f539610444b1cd479c59764a8df1f919d67070343b6058ba591412aaa07003</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1038/leu.2017.323$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1038/leu.2017.323$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29104287$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Molenaar, R J</creatorcontrib><creatorcontrib>Pleyer, C</creatorcontrib><creatorcontrib>Radivoyevitch, T</creatorcontrib><creatorcontrib>Sidana, S</creatorcontrib><creatorcontrib>Godley, A</creatorcontrib><creatorcontrib>Advani, A S</creatorcontrib><creatorcontrib>Gerds, A T</creatorcontrib><creatorcontrib>Carraway, H E</creatorcontrib><creatorcontrib>Kalaycio, M</creatorcontrib><creatorcontrib>Nazha, A</creatorcontrib><creatorcontrib>Adelstein, D J</creatorcontrib><creatorcontrib>Nasr, C</creatorcontrib><creatorcontrib>Angelini, D</creatorcontrib><creatorcontrib>Maciejewski, J P</creatorcontrib><creatorcontrib>Majhail, N</creatorcontrib><creatorcontrib>Sekeres, M A</creatorcontrib><creatorcontrib>Mukherjee, S</creatorcontrib><title>Risk of developing chronic myeloid neoplasms in well-differentiated thyroid cancer patients treated with radioactive iodine</title><title>Leukemia</title><addtitle>Leukemia</addtitle><addtitle>Leukemia</addtitle><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
<0.001). These data suggest that RAI treatment for WDTC is associated with increased risk of MDS with short latency and poor survival.</description><subject>631/67/1990/1673</subject><subject>631/67/1990/2331</subject><subject>631/67/2324</subject><subject>692/308/174</subject><subject>692/499</subject><subject>Cancer</subject><subject>Cancer Research</subject><subject>Care and treatment</subject><subject>Chronic myeloid leukemia</subject><subject>Complications and side effects</subject><subject>Confidence intervals</subject><subject>Critical Care Medicine</subject><subject>Epidemiology</subject><subject>Health aspects</subject><subject>Health risk assessment</subject><subject>Hematology</subject><subject>Intensive</subject><subject>Internal Medicine</subject><subject>Iodine</subject><subject>Iodine radioisotopes</subject><subject>Ionizing radiation</subject><subject>Latency</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Myelodysplastic syndrome</subject><subject>Neoplasms</subject><subject>Oncology</subject><subject>original-article</subject><subject>Patients</subject><subject>Prognosis</subject><subject>Radioiodine</subject><subject>Radiotherapy</subject><subject>Regional development</subject><subject>Risk assessment</subject><subject>Risk factors</subject><subject>Survival</subject><subject>Thyroid</subject><subject>Thyroid 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intervals</topic><topic>Critical Care Medicine</topic><topic>Epidemiology</topic><topic>Health aspects</topic><topic>Health risk assessment</topic><topic>Hematology</topic><topic>Intensive</topic><topic>Internal Medicine</topic><topic>Iodine</topic><topic>Iodine radioisotopes</topic><topic>Ionizing radiation</topic><topic>Latency</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Myelodysplastic syndrome</topic><topic>Neoplasms</topic><topic>Oncology</topic><topic>original-article</topic><topic>Patients</topic><topic>Prognosis</topic><topic>Radioiodine</topic><topic>Radiotherapy</topic><topic>Regional development</topic><topic>Risk assessment</topic><topic>Risk factors</topic><topic>Survival</topic><topic>Thyroid</topic><topic>Thyroid cancer</topic><topic>Thyroidectomy</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Molenaar, R J</creatorcontrib><creatorcontrib>Pleyer, 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N</au><au>Sekeres, M A</au><au>Mukherjee, S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk of developing chronic myeloid neoplasms in well-differentiated thyroid cancer patients treated with radioactive iodine</atitle><jtitle>Leukemia</jtitle><stitle>Leukemia</stitle><addtitle>Leukemia</addtitle><date>2018-04-01</date><risdate>2018</risdate><volume>32</volume><issue>4</issue><spage>952</spage><epage>959</epage><pages>952-959</pages><issn>0887-6924</issn><eissn>1476-5551</eissn><abstract>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
<0.001). These data suggest that RAI treatment for WDTC is associated with increased risk of MDS with short latency and poor survival.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>29104287</pmid><doi>10.1038/leu.2017.323</doi><tpages>8</tpages></addata></record> |
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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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