Second malignancies following treatment of chronic myeloid leukaemia in the tyrosine kinase inhibitor era

Research output: Contribution to journalArticle


Given that tyrosine kinase inhibitors (TKIs) have dramatically improved the survival of patients with chronic myeloid leukaemia (CML), we were interested in examining the possible risk of long-term adverse events, such as the emergence of other neoplasms. Therefore, we studied the development of second malignancies in 868 patients diagnosed with CML between 2002 and 2011 using the Swedish CML register, cross-linked to the Swedish Cancer register. With a median follow-up of 37 (range 0-99)years, 65 (75%) patients developed 75 second malignancies (non-haematological), 52 of which were of the invasive type. Compared to expected rates in the background population, the risk of second malignancies was higher in the CML cohort, with a standardized incidence ratio (SIR) of 152 (95% CI 113-199). The SIR before and after the second year following diagnosis of CML was 158 and 147, respectively. Among specific cancer types, gastrointestinal and nose and throat cancer were significantly increased. Founded on a population-based material, our results indicate that CML patients treated in the TKI era are at an increased risk of developing a second malignancy, with indications that this risk may more likely be linked to CML itself rather than to the TKI treatment.


  • Niklas Gunnarsson
  • Leif Stenke
  • Martin Hoglund
  • Fredrik Sandin
  • Magnus Bjorkholm
  • Arta Dreimane
  • Mats Lambe
  • Berit Markevarn
  • Ulla Olsson-Stromberg
  • Johan Richter
  • Hans Wadenvik
  • Jonas Wallvik
  • Anders Sjalander
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Hematology


  • chronic myeloid leukaemia, treatment, malignancy
Original languageEnglish
Pages (from-to)683-688
JournalBritish Journal of Haematology
Issue number5
Publication statusPublished - 2015
Publication categoryResearch