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Risk Factors beyond Chemotherapy Exposure for Secondary Myeloid Neoplasms after Hematologic Cancers: A SEER-Based
Abhay Singh1, Theresa Hahn2, Rahul Mishra3
1Department of Hematology Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio.
Cancer Research Communications
|November 14, 2025
Summary
Secondary myeloid neoplasms (sMNs) are late effects of cancer treatment. This study identified chemotherapy, G-CSF, and autoimmune conditions as key risk factors for sMNs in lymphoma and myeloma patients.
Area of Science:
- Oncology
- Hematology
- Epidemiology
Background:
- Improving survival rates for lymphoid malignancies necessitate understanding long-term treatment effects.
- Secondary myeloid neoplasms (sMNs) are a critical late effect impacting cancer survivorship.
- Identifying risk factors for sMNs is crucial for patient care and prevention strategies.
Purpose of the Study:
- To investigate the risk factors and cumulative incidence of secondary myeloid neoplasms (sMNs).
- To analyze sMN risk in patients with diffuse large B-cell lymphoma (DLBCL), follicular lymphoma (FL), and multiple myeloma.
- To identify population-level risk factors for sMN development.
Main Methods:
- Large-scale population-based study utilizing SEER-Medicare data.
- Analysis of patients diagnosed with DLBCL, FL, and multiple myeloma between 2000-2011.
- Follow-up through 2015 to assess cumulative incidence and risk factors.
Main Results:
- Cumulative incidence of sMNs increased with longer follow-up in FL patients; plateaued after 60 months in multiple myeloma.
- More recent DLBCL diagnoses (2004-2011) showed higher sMN incidence compared to earlier diagnoses (2000-2003).
- Older age, chemotherapy, G-CSF exposure, and chronic autoimmune conditions were significant risk factors for sMNs across malignancies.
Conclusions:
- Chemotherapy and G-CSF exposure are significant mediators of sMN risk.
- Chronic autoimmune conditions represent a novel identified risk factor for sMNs in DLBCL.
- Findings highlight the complex pathogenesis of sMNs and inform survivorship care.
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