Second primary malignancy risk after Hodgkin lymphoma treatment among HIV-uninfected and HIV-infected survivors.

Second primary malignancy risk after Hodgkin lymphoma treatment among HIV-uninfected and HIV-infected survivors.
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DOI:
10.1080/10428194.2021.2020775
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发表时间:
2022-05
影响因子:
2.6
通讯作者:
--
中科院分区:
医学4区
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--
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我们比较了未感染hiv和感染hiv的霍奇金淋巴瘤(HL)幸存者的继发原发性恶性肿瘤风险(SPM)。我们使用加州癌症登记处1990年至2015年(包括所有年龄)诊断为HL的患者的数据,并使用标准化发病率比(SIRs)和多变量竞争风险模型进行分析。在19,667名幸存者中,有735人感染了艾滋病毒。与一般人群相比,hiv感染者发生SPM的风险增加了2.66倍,未感染hiv的幸存者增加了1.92倍。在艾滋病毒感染的幸存者中,发展为SPM的中位时间(5.4年)短于未感染艾滋病毒的患者(8.1年)。此外,SPM的最高风险在诊断后<2年的hiv感染幸存者中(SIR = 4.47),而在诊断后≥20年的hiv未感染幸存者中(SIR = 2.39)风险最高。SPMs的风险持续了几十年,在艾滋病毒感染的幸存者中更高,这表明这些患者应该从长期监测和癌症预防实践中受益。
We compared secondary primary malignancy risk (SPM) in HIV-uninfected and HIV-infected Hodgkin lymphoma (HL) survivors. We used data from the California Cancer Registry on patients diagnosed with HL from 1990 to 2015 (all ages included), and standardized incidence ratios (SIRs) and multivariable competing risk models for analyses. Of 19,667 survivors, 735 were HIV-infected. Compared with the general population, the risk of SPM was increased by 2.66-fold in HIV-infected and 1.92-fold in HIV-uninfected survivors. Among HIV-infected survivors, median time to development of SPM was shorter (5.4 years) than in HIV-uninfected patients (8.1 years). Additionally, the highest risk of SPM was observed <2 years after diagnosis in HIV-infected survivors (SIR = 4.47), whereas risk was highest ≥20 years after diagnosis (SIR = 2.39) in HIV-uninfected survivors. The risk of SPMs persisted for decades and was higher among HIV-infected survivors, suggesting that these patients should benefit from long-term surveillance and cancer prevention practices.
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