Table 4 Risk factors for development of... | American Society of Hematology

Table 4

Risk factors for development of a third malignancy after a second malignancy in HL survivors

Risk factor	All malignancies				Solid nonbreast tumor after solid nonbreast tumor
Risk factor	Cohort, n = 3122	2nd, n = 832	3rd, n = 126	HR	95% CI	Inter action P	Cohort, n = 3122	2nd, n = 514	3rd, n = 51	HR	95% CI	Interaction P
Sex						.003						.744
Female	1346	422	84	1.0			1346	195	19	1.0
Male	1776	410	42				1776	319	32	1.3	1.0-1.5
Male (2nd malignancy)				0.7	0.6-0.9
Male (3rd malignancy)				0.4	0.3-0.6
Age at HL treatment, y						.381						.223
<25	1288	293	52	1.0			1288	158	14	1.0
25-34	1011	270	45	1.4	1.2-1.7		1011	168	16	1.7	1.3-2.1
35-50	823	269	29	2.4	2.0-2.8		823	188	21	3.4	2.7-4.3
HL treatment
RT, <5 y*						.022						.027
No	339	43	3	1.0			339	29	2	1.0
Above diaphragm	1339	343	44				1339	210	14
Above and below diaphragm†	1444	446	79				1441	275	35
Above diaphragm (2nd malignancy)				2.1	1.5-2.9					2.2	1.5-3.3
Above diaphragm (3rd malignancy)				2.8	0.9-9.0					2.0	0.4-8.5
Above and below diaphragm (2nd malignancy)				2.6	1.9-3.7					2.8	1.9-4.1
Above and below diaphragm (3rd malignancy)				5.2	1.6-16.8					5.3	1.3-22.2
CT, <5 y*						.003						.769
No	1025	334	69	1.0			1025	193	21	1.0
Yes	2096	498	57				2096	321	30	1.1	0.9-1.4
Yes (2nd malignancy)				0.9	0.8-1.1
Yes (3rd malignancy)				0.6	0.4-0.8
RT, ≥ 5 y‡						.764						.846
No	96	22	2	1.0			96	15	1	1.0
Above diaphragm	46	18	4	2.4	1.5-3.9		46	15	1	2.9	1.7-4.9
Below diaphragm	54	16	2	1.6	0.9-2.7		54	9	1	1.6	0.8-3.2
CT, ≥ 5 y‡						.274						.224
No	39	13	4	1.0			39	10	2	1.0
Yes	157	43	4	0.9	0.8-1.1		157	29	1	1.2	0.7-2.0
Relapse <5 y after HL treatment						.475						.217
No	2450	629	98	1.0			2450	393	35	1.0
Yes	672	203	28	1.6	1.3-1.9		672	121	16	1.5	1.1-1.9

Risk factor	All malignancies				Solid nonbreast tumor after solid nonbreast tumor
Risk factor	Cohort, n = 3122	2nd, n = 832	3rd, n = 126	HR	95% CI	Inter action P	Cohort, n = 3122	2nd, n = 514	3rd, n = 51	HR	95% CI	Interaction P
Sex						.003						.744
Female	1346	422	84	1.0			1346	195	19	1.0
Male	1776	410	42				1776	319	32	1.3	1.0-1.5
Male (2nd malignancy)				0.7	0.6-0.9
Male (3rd malignancy)				0.4	0.3-0.6
Age at HL treatment, y						.381						.223
<25	1288	293	52	1.0			1288	158	14	1.0
25-34	1011	270	45	1.4	1.2-1.7		1011	168	16	1.7	1.3-2.1
35-50	823	269	29	2.4	2.0-2.8		823	188	21	3.4	2.7-4.3
HL treatment
RT, <5 y*						.022						.027
No	339	43	3	1.0			339	29	2	1.0
Above diaphragm	1339	343	44				1339	210	14
Above and below diaphragm†	1444	446	79				1441	275	35
Above diaphragm (2nd malignancy)				2.1	1.5-2.9					2.2	1.5-3.3
Above diaphragm (3rd malignancy)				2.8	0.9-9.0					2.0	0.4-8.5
Above and below diaphragm (2nd malignancy)				2.6	1.9-3.7					2.8	1.9-4.1
Above and below diaphragm (3rd malignancy)				5.2	1.6-16.8					5.3	1.3-22.2
CT, <5 y*						.003						.769
No	1025	334	69	1.0			1025	193	21	1.0
Yes	2096	498	57				2096	321	30	1.1	0.9-1.4
Yes (2nd malignancy)				0.9	0.8-1.1
Yes (3rd malignancy)				0.6	0.4-0.8
RT, ≥ 5 y‡						.764						.846
No	96	22	2	1.0			96	15	1	1.0
Above diaphragm	46	18	4	2.4	1.5-3.9		46	15	1	2.9	1.7-4.9
Below diaphragm	54	16	2	1.6	0.9-2.7		54	9	1	1.6	0.8-3.2
CT, ≥ 5 y‡						.274						.224
No	39	13	4	1.0			39	10	2	1.0
Yes	157	43	4	0.9	0.8-1.1		157	29	1	1.2	0.7-2.0
Relapse <5 y after HL treatment						.475						.217
No	2450	629	98	1.0			2450	393	35	1.0
Yes	672	203	28	1.6	1.3-1.9		672	121	16	1.5	1.1-1.9

HRs based on Cox recurrent event analyses with marginal approach. 2nd, second malignancy; 3rd, third malignancy.

y, years.

Includes all relapse treatment within 5 years after HL (672 patients with relapse within 5 years).

Includes 316 patients treated with radiotherapy below the diaphragm only.

Treatment of relapse 5 years or more after HL, time-dependent (196 patients with relapse ≥5 years after HL).