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Annals of Oncology Advance Access originally published online on July 22, 2008
Annals of Oncology 2009 20(1):103-109; 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

hematologic malignancies

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.

Key words: 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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