Secondary malignancy (therapy-related cancer)
A new, different cancer caused by the treatment of the first one: leukaemia after alkylating chemotherapy or PARP inhibitors, solid tumours in irradiated tissue decades later, and rarely T-cell lymphoma after CAR-T. Rare per patient, but it matters most for those cured young.
Therapy-related myeloid neoplasms (MDS/AML) follow alkylators (5-7 years, often with TP53 mutations and complex karyotype), topoisomerase II inhibitors (2-3 years, MLL rearrangements), PARP inhibitors (about 1-2% in maintenance trials), lenalidomide maintenance and radiotherapy, and carry a poor prognosis; they often arise from pre-existing clonal haematopoiesis. Radiation-induced solid cancers (breast cancer after Hodgkin mantle radiotherapy, sarcomas, thyroid cancer after childhood radiation) appear 10-30 years later and drive the search for less radiation in curable young patients. Secondary T-cell malignancies after CAR-T (FDA boxed warning, 2024) are rare and mostly unrelated to insertional mutagenesis. Second primary cancers also reflect shared risk factors (tobacco in head and neck and lung cancer) and genetic syndromes.
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not linked directly; found by shared links- TermCardiotoxicity (LVEF decline, cardiomyopathy)
Shares Late effects and survivorship toxicity, Anthracyclines (doxorubicin, epirubicin).
- TermDe-escalation, escalation and response-adapted therapy
Shares ABVD, BEACOPP and BrECADD (Hodgkin lymphoma regimens), Late effects and survivorship toxicity.
- ProductDoxorubicin
Shares ABVD, BEACOPP and BrECADD (Hodgkin lymphoma regimens), Anthracyclines (doxorubicin, epirubicin).