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Annals of Oncology Advance Access published online on July 22, 2008
Annals of Oncology, doi:10.1093/annonc/mdn530
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© The Author 2008. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

Acute myeloid leukemia after breast cancer: a population-based comparison with hematological malignancies and other cancers

G. Beadle1, P. Baade2 and L. Fritschi3

1 Department of Translational Research Laboratory, Queensland Institute of Medical Research, Brisbane
2 Department of Viertel Cancer Centre, The Cancer Council Queensland, Brisbane
3 Department of Cancer Medicine, Western Australian Institute for Medical Research, Perth, Australia

Correspondence to: Dr G. Beadle, Queensland Institute of Medical Research, Post Office Royal Brisbane Hospital, Herston, Queensland 4029, Australia. Tel: +617-3870-4255; Fax: +617-3870-4305; E-mail: geoffBe{at}qimr.edu.au

Background: Clinical trials frequently report acute myeloid leukemia (AML) as a complication of adjuvant chemotherapy for breast cancer (BC).

Patients and methods: This retrospective population-based study investigated AML risk after a prior BC diagnosis and compared the results with women after a prior diagnosis of hematological malignancies (HM), other cancers combined (OCC), and the age-matched Australian female population.

Results: Women with a prior BC diagnosis had 2.56 times the risk of developing AML compared with the Australian female population (P < 0.001). AML risk was also elevated after prior HM and OCC diagnoses (4.73, P < 0.001, and 1.70, P < 0.001, respectively). Although the incidence of AML rose sharply with age in all cohorts, the age-specific relative risk was highest in the 30- to 49-age-group and decreased with increasing age. AML risk increased with the duration of follow-up but there was no change of risk during the 23 years of this study.

Conclusion: AML risk was elevated after a prior diagnosis of BC but there was no evidence of an increasing risk of AML after a BC diagnosis or, in any of the other cancer cohorts, during this era of expansion of the evidence base for more intensive treatments.

acute myeloid leukemia, all cancers, breast cancer, epidemiology, hematological malignancies

Received for publication June 18, 2008. Accepted for publication June 23, 2008.


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