Abstract
Although gefitinib, an epidermal growth factor receptor tyrosine kinase inhibitor, has been shown a significant activity for recurrent non-small-cell lung cancer (NSCLC), its long-term adverse effect with its continuous usage has hitherto not been clearly elucidated. Subjects were 108 consecutive NSCLC cases who were treated with gefitinib between November 2001 and December 2004 at our single institution. A crude incidence rate ratio was calculated by ratio of crude incidence rate in our subject to population-based incident rate of all leukemia (ICD: C91-95) in the same region. The 95% confidence intervals (CIs) were calculated based upon a Poisson distribution. Three cases of acute promyelocytic leukemia (APL) occurred during gefitinib treatment, and these patients' past treatment histories are presented herein. No other malignancy was identified. All of the cases were diagnosed at the stage of mild-to-moderate cytopenia, especially thrombocytopenia, without disseminated intravascular coagulation. All presented a normal karyotype with positive PML-RARα in RT-PCR, indicating submicroscopic translocation. They responded well to APL treatments, including all-trans-retinoic acid. The crude incident rate ratio was 639.9 (95% confidence interval: 131.6-1,878.9, P <0.0001) when the APL incidence in this cohort was compared to all leukemia cases in the general population in the same district in Japan. Thus we had three cases of secondary APL patients within the gefitinib-treated NSCLC cohort. Although we cannot exclude an effect of past exposure of other cytotoxic agents and radiotherapy as a cause of APL, APL inducibility of gefitinib should be clarified in the further study.
| Original language | English |
|---|---|
| Pages (from-to) | 349-354 |
| Number of pages | 6 |
| Journal | American Journal of Hematology |
| Volume | 81 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - May 2006 |
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Keywords
- Acute promyelocytic leukemia
- Gefitinib
- Non-small-cell lung cancer
- Second malignancy
ASJC Scopus subject areas
- Hematology
Cite this
Clustered incidence of acute promyelocytic leukemia during gefitinib treatment for non-small-cell lung cancer : Experience at a single institution. / Matsuo, Keitaro; Kiura, Katsuyuki; Tabata, Masahiro; Uchida, Akiko; Hotta, Katsuyuki; Niiya, Daigo; Kubonishi, Shiro; Ogino, Atsuko; Fujiwara, Yoshiro; Nakajima, Hiromi; Shinagawa, Katsuji; Ishimaru, Fumihiko; Ueoka, Hiroshi; Tanimoto, Mitsune.
In: American Journal of Hematology, Vol. 81, No. 5, 05.2006, p. 349-354.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Clustered incidence of acute promyelocytic leukemia during gefitinib treatment for non-small-cell lung cancer
T2 - Experience at a single institution
AU - Matsuo, Keitaro
AU - Kiura, Katsuyuki
AU - Tabata, Masahiro
AU - Uchida, Akiko
AU - Hotta, Katsuyuki
AU - Niiya, Daigo
AU - Kubonishi, Shiro
AU - Ogino, Atsuko
AU - Fujiwara, Yoshiro
AU - Nakajima, Hiromi
AU - Shinagawa, Katsuji
AU - Ishimaru, Fumihiko
AU - Ueoka, Hiroshi
AU - Tanimoto, Mitsune
PY - 2006/5
Y1 - 2006/5
N2 - Although gefitinib, an epidermal growth factor receptor tyrosine kinase inhibitor, has been shown a significant activity for recurrent non-small-cell lung cancer (NSCLC), its long-term adverse effect with its continuous usage has hitherto not been clearly elucidated. Subjects were 108 consecutive NSCLC cases who were treated with gefitinib between November 2001 and December 2004 at our single institution. A crude incidence rate ratio was calculated by ratio of crude incidence rate in our subject to population-based incident rate of all leukemia (ICD: C91-95) in the same region. The 95% confidence intervals (CIs) were calculated based upon a Poisson distribution. Three cases of acute promyelocytic leukemia (APL) occurred during gefitinib treatment, and these patients' past treatment histories are presented herein. No other malignancy was identified. All of the cases were diagnosed at the stage of mild-to-moderate cytopenia, especially thrombocytopenia, without disseminated intravascular coagulation. All presented a normal karyotype with positive PML-RARα in RT-PCR, indicating submicroscopic translocation. They responded well to APL treatments, including all-trans-retinoic acid. The crude incident rate ratio was 639.9 (95% confidence interval: 131.6-1,878.9, P <0.0001) when the APL incidence in this cohort was compared to all leukemia cases in the general population in the same district in Japan. Thus we had three cases of secondary APL patients within the gefitinib-treated NSCLC cohort. Although we cannot exclude an effect of past exposure of other cytotoxic agents and radiotherapy as a cause of APL, APL inducibility of gefitinib should be clarified in the further study.
AB - Although gefitinib, an epidermal growth factor receptor tyrosine kinase inhibitor, has been shown a significant activity for recurrent non-small-cell lung cancer (NSCLC), its long-term adverse effect with its continuous usage has hitherto not been clearly elucidated. Subjects were 108 consecutive NSCLC cases who were treated with gefitinib between November 2001 and December 2004 at our single institution. A crude incidence rate ratio was calculated by ratio of crude incidence rate in our subject to population-based incident rate of all leukemia (ICD: C91-95) in the same region. The 95% confidence intervals (CIs) were calculated based upon a Poisson distribution. Three cases of acute promyelocytic leukemia (APL) occurred during gefitinib treatment, and these patients' past treatment histories are presented herein. No other malignancy was identified. All of the cases were diagnosed at the stage of mild-to-moderate cytopenia, especially thrombocytopenia, without disseminated intravascular coagulation. All presented a normal karyotype with positive PML-RARα in RT-PCR, indicating submicroscopic translocation. They responded well to APL treatments, including all-trans-retinoic acid. The crude incident rate ratio was 639.9 (95% confidence interval: 131.6-1,878.9, P <0.0001) when the APL incidence in this cohort was compared to all leukemia cases in the general population in the same district in Japan. Thus we had three cases of secondary APL patients within the gefitinib-treated NSCLC cohort. Although we cannot exclude an effect of past exposure of other cytotoxic agents and radiotherapy as a cause of APL, APL inducibility of gefitinib should be clarified in the further study.
KW - Acute promyelocytic leukemia
KW - Gefitinib
KW - Non-small-cell lung cancer
KW - Second malignancy
UR - http://www.scopus.com/inward/record.url?scp=33646471700&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33646471700&partnerID=8YFLogxK
U2 - 10.1002/ajh.20569
DO - 10.1002/ajh.20569
M3 - Article
C2 - 16628731
AN - SCOPUS:33646471700
VL - 81
SP - 349
EP - 354
JO - American Journal of Hematology
JF - American Journal of Hematology
SN - 0361-8609
IS - 5
ER -