Background:Radioactive iodine (RAI) ablation therapy is a common minimally invasive treatment for patients diagnosed with differentiated thyroid cancer (DTC). Although previous studies have identified a link between RAI and the mortality from secondary solid cancers, the connection between RAI and leukemia remains under-researched. This study investigated the differential risk of leukemia and its subtypes in DTC patients following RAI treatment.Methods:DTC patients from the Surveillance, Epidemiology, and End Results (SEER) Registry 17 (2000–2019) were analyzed. The standard incidence ratio (SIR) and excess risk (ER) compared to the reference population were calculated.Results:Out of 196,569 DTC patients, 1381 patients developed various types of hematological malignancies. Leukemia was diagnosed in 508 of these patients, and it had the highest risk among the malignancies studied, with an SIR of 1.74 (95%CI: 1.59–1.9). The RAI group had an SIR of 2.12 (95%CI: 1.87–2.39), while the non-RAI group had an SIR was 1.45 (95%CI: 1.37–1.52) (p< 0.001). Those diagnosed before the age of 55 years had a conspicuously elevated risk (SIR 2.74) compared to those diagnosed at 55 years or older (SIR 1.53). American Indian/Alaska Native survivors manifested a pronounced leukemia risk with an SIR of 7.63 (95%CI: 2.46–17.8).Conclusions:RAI treatment increased the risk of developing leukemia when serving as adjuvant therapy in surgical patients (SIR 2.12). There exists a significant association between RAI treatment in DTC patients and the incidence of leukemia. This susceptibility seems to be modulated by factors including time since diagnosis, age, gender, and racial background.
背景：放射性碘（RAI）消融治疗是分化型甲状腺癌（DTC）患者常用的微创治疗方法。尽管既往研究已发现RAI与继发性实体癌死亡率之间存在关联，但RAI与白血病的关系仍缺乏深入研究。本研究探讨了DTC患者接受RAI治疗后白血病及其亚型的差异化风险。 方法：本研究分析了监测、流行病学和最终结果（SEER）登记库17（2000-2019年）中的DTC患者数据。计算了与参考人群相比的标准发病率比（SIR）和超额风险（ER）。 结果：在196,569名DTC患者中，有1381名患者罹患了各类血液系统恶性肿瘤。其中508名患者被诊断为白血病，在所研究的恶性肿瘤中风险最高，SIR为1.74（95%CI：1.59-1.9）。接受RAI治疗组的SIR为2.12（95%CI：1.87-2.39），而未接受RAI治疗组的SIR为1.45（95%CI：1.37-1.52）（p<0.001）。与55岁及以上确诊者（SIR 1.53）相比，55岁前确诊者的风险显著升高（SIR 2.74）。美国印第安人/阿拉斯加原住民幸存者表现出明显的白血病风险，SIR高达7.63（95%CI：2.46-17.8）。 结论：RAI作为手术患者的辅助治疗时，会增加罹患白血病的风险（SIR 2.12）。DTC患者的RAI治疗与白血病发病率之间存在显著关联。这种易感性似乎受到确诊后时间、年龄、性别和种族背景等因素的调节。
Beyond the Burn: Leukemia Threats Following Radioactive Iodine Ablation Therapy for Thyroid Cancer
肿瘤(癌症)患者之家