Second malignancy risk elevated in patients with cutaneous T-cell lymphoma

Men with a prior cutaneous T-cell lymphoma were at increased risk for a second malignancy, according to a study.

“Patients with cutaneous T-cell lymphoma (CTCL) are at a higher risk of developing second malignancies,” Amrita Goyal, MD, of the department of dermatology in the division of hematology, oncology and transplantation and the department of radiation oncology at the University of Minnesota, and colleagues wrote. “However, rates of incidence vary significantly across studies.”

In the current systematic review and meta-analysis, Goyal and colleagues identified 10 relevant studies and 12 patient cohorts published between 1950 and 2019. The aim was to assess second malignancy risk in patients with CTCL.

The study populations had a mean patient age range of 44.6 to 68 years.

The data sets contained 63 to 6,742 patients. Results showed a range of 5.9% to 16.8% for second malignancy rates. Men were more likely than women to develop a second malignancy, with male-to-female ratios of 1.2:1 to 2.9:1, according to the findings.

The mean duration of time between initial CTCL diagnosis and second malignancy diagnosis ranged from 2.1 to 5.4 years (mean duration, 3.29 years; 95% CI, 2.69-5.15).

Data on second malignancies showed that non-Hodgkin lymphoma (NHL) was most common at 20%, followed by Hodgkin lymphoma (HL) at 17.8%. Other commonly reported second malignancies were lung cancer (15.1%), bladder cancer (8.3%) and colon cancer (8%). Female breast cancer was reported in 6.5% of patients, while 3.2% developed melanoma and 2.9% had kidney cancer as their second malignancy.

The overall standardized incidence ratio (SIR) of second malignancies was 2.18 (95% CI, 1.43-2.93), according to meta-analysis results. Looking deeper into these findings, HL carried a SIR of 15.25 (95% CI, 7.7-22.79), while the SIR was 4.96 (95% CI, 3.58-6.33) for NHL, 1.69 (95% CI, 1.18-2.21) for lung cancer, 1.72 (95% CI, 1.18-2.21) for bladder cancer and 3.09 (95% CI, 1.77-6.43) for melanoma.

“We find that patients with CTCL are at increased risk of second malignancies, especially Hodgkin and non-Hodgkin lymphoma, lung cancer, bladder cancer and melanoma,” the researchers wrote.

They suggested that the data indicate that CTCL populations should be on the radar for ongoing cancer. “Early detection may decrease the morbidity burden of second malignancies, thus providing a strong rationale for prospective screening studies.”