Second Malignancies Among Older Patients With Classical MPN Treated With Hydroxyurea

[Manouche]

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In this retrospective cohort study of 4023 patients aged ≥66 years with classical Philadelphia chromosome–negative myeloproliferative neoplasms (MPN), there was no significant difference in the incidence of solid or hematologic second malignancies in patients treated with hydroxyurea compared with those not treated with hydroxyurea.This result suggests that, among older patients with MPN, the use of hydroxyurea is not associated with an increased risk of second malignancies.

Published in Benign HematologyJournal Scan / Research · August 09, 2022

[mhos61]

Woohoo! Something positive about hydrea for a change, so good to hear.

Thanks Manouche

[Belltech1275 in reply to mhos61]

Good news another stress less for us Hydrea users.

[EPguy]

Thanks for the latest. It is a big study and reassuring.

One limitation is the follow up time of <<3.25 years (range of: 2.10-5.00)>> It seem fairly short, while these concerns are usually tied to many years or decades of HU. I might be missing something however.

If not I'd suggest they qualify the summary to<<Our results suggest that the use of HU does not increase the risk of SM in older MPN patients over a three year period. >>

pubmed.ncbi.nlm.nih.gov/359...

[Manouche in reply to EPguy]

« …As SEER cancer information was only available up to the end of 2017, we identified SM using SEER data for the years 2010-2017 and Medicare claims for the years 2018-2019 ».

[Manouche in reply to EPguy]

Hi EPguy,Thank you for your input, but again, abstracts are not enough to understand statistics.

« This large, comprehensive US registry study followed 4023 older adults with MPN for up to 10 years with 490 patients developing SM. The cumulative incidence probability of SM was 19.88% (95% confidence interval [CI] 17.16-22.75%) among 2683 HU users and 22.31% (95% CI: 17.51-27.47%) among 1340 non-users. Use of HU did not impact the risk of developing SM overall as well as solid and hematologic SM and AML/MDS in particular ».

[EPguy in reply to Manouche]

I found only the summary, so that is the "something I'm missing". Ainslie here seems to have a full copy, while you also have a full copy showing the 10 year duration.

In the summary "After a median follow-up of 3.25..." What were they referring to?

Is it possible we're looking at three different papers? Is there a link for the full report?

You note "again" re abstracts. Is there another example that I misunderstood via an abstract?

[ainslie]

I dont think this study is very meaningful. If you read the full paper the median study period for the HU users was 3.58 years, this is too short. It is well know HU causes skin cancers , it says that in the leaflet with the meds. I know several long term users of HU and they say when they are on it it brings out skin cancers when they cycle it with Peg or they dont have skin cancers, this is in the US where more sun than UK. Any experts who I have discussed this with especially the Pro Pegasys ones say HU should cause any issues for 2-5 years. Any haem will confirm that HU causes skin cancers and is dependant on dose, duration of treatment, and current or previous sun exposure. I note that none of the writers of that paper are any of the well know MPN experts we know. The issue of other secondary cancers including Leukaemia transformation is much less clear and disputed by the best experts. No drug is perfect and although Peg does not cuase skin cancers it is not tolerated by quite a few (Hasslebach said to me up to 40% long term) and not everyone can get Rux and it also has its issues with allegidly lowering immunity and possible skin cancers. We need better drugs. Skin cancer is very treatable these days if treated early, be careful with the sun in the meantime.

[Meatloaf9 in reply to ainslie]

I don't think we need better drugs, we need a cure. Better drugs would be nice in the meantime. Best to you.

[EPguy in reply to ainslie]

I agree HU is well known for non-melanoma skin cancers. But if this report had a 10 year duration for this aspect, that would to be new info. Seems we need to reconcile the 3 vs 10 year study discrepancy noted here.

[Bluetop]

Oh that is encouraging news. Thanks for posting.