Risk of Hematologic Malignancies After Radioiodine Treatment of Well-Differentiated Thyroid Cancer

• DOI: 10.1200/jco.2017.75.0232
• Publication Date: 2017-12-18T20:57:35Z
• Authors: Remco J. Molenaar; Surbhi Sidana; Tomas Radivoyevitch; Anjali S. Advani; Aaron T. Gerds; Hetty E. Carraway; Dana Angelini; Matt Kalaycio; Aziz Nazha; David J. Adelstein; Christian Nasr; Jaroslaw P. Macie...; Navneet S. Majhail; Mikkael A. Sekeres; Sudipto Mukherjee
• Keywords: Interquartile range

Purpose To investigate the risk and outcomes of second hematologic malignancies (SHMs) in a population-based cohort patients with well-differentiated thyroid cancer (WDTC) treated or not radioactive iodine (RAI). Methods Patients WDTC were identified from SEER registries. Competing regression analysis was performed to calculate risks SHMs that occurred after treatment SHM development assessed. Results Of 148,215 WDTC, 53% received surgery alone 47% RAI. In total, 783 developed an median interval 6.5 years (interquartile range, 3.3 11.2 years) diagnosis. multivariable analysis, compared those undergoing thyroidectomy alone, RAI associated increased early developing acute myeloid leukemia (AML; hazard ratio, 1.79; 95% CI, 1.13 2.82; P = .01) chronic (CML; 3.44; 1.87 6.36; < .001). This AML CML seen even low-risk intermediate-risk tumors. Occurrence but shorter overall survival matched controls (8.0 v 31.0 years; addition, trended toward inferior de novo (median survival, 1.2 2.9 .06). Conclusion had no other malignancies. arises has poor prognosis. use should be limited high-risk disease features, adjuvant monitored for as part surveillance.