{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T05:48:39Z","timestamp":1777009719528,"version":"3.51.4"},"reference-count":21,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T00:00:00Z","timestamp":1776729600000},"content-version":"vor","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Secondary primary solid malignancies (SPSMs) significantly impact long\u2010term outcomes in lymphoma patients. However, subtype\u2010specific differences remain unclear, such as diffuse large B\u2010cell lymphoma (DLBCL) and follicular lymphoma (FL).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This study collected 1,377 DLBCL and 489 FL patients, identifying 50 DLBCL and 31 FL cases with SPSMs. Clinical characteristics, SPSM types, and survival were compared in these 81 patients. Demographic, clinical, treatment\u2010related variables (including radiotherapy for primary lymphoma, recorded as yes\/no), and survival outcomes were collected. Overall survival (OS) was analyzed using Kaplan\u2013Meier estimates and Cox proportional hazards models. The cumulative incidence of SPSMs was evaluated with competing risk analysis (death as a competing event), and group comparisons were performed with Gray's test. Prognostic factors identified in univariable analysis (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05) were included in a multivariable Cox model. A nomogram was developed, with discriminative ability assessed by the area under the receiver operating characteristic curve (ROC). Statistical significance was set at\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      SPSMs were observed more frequently in FL (6.34%) than DLBCL (3.63%). Thyroid cancer predominated (22.2%, 18\/81). DLBCL patients developed SPSMs earlier than FL patients (median 28.47 vs. 41.77\u2009months,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.031), though cumulative incidence accounting for competing risks did not differ significantly (Gray's test\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.34). DLBCL patients with SPSMs had inferior OS compared to FL patients (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04). Non\u2010GCB DLBCL showed greater SPSM diversity and survival disadvantage. Multivariable analysis identified FL (vs. DLBCL) subtype (HR\u2009=\u20090.328,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.018), bone marrow infiltration (HR\u2009=\u20092.815,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.014), initial radiotherapy before SPSM diagnosis (HR\u2009=\u20093.475,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005), and shorter time to SPSM development (HR\u2009=\u20090.973 per month,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.021) as independent prognostic factors for worse OS. The nomogram model showed acceptable discrimination, with an AUC of 0.761 in the time\u2010dependent ROC analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      This study provides novel insights into SPSM characteristics and prognostic differences in DLBCL and FL patients within a Chinese cohort. SPSMs in FL patients were observed more frequently, while DLBCL patients, particularly those with non\u2010GCB subtypes, experience earlier SPSM onset and poorer survival. The validated nomogram, incorporating lymphoma\u2010related factors, enables personalized risk stratification. However, the single\u2010center design, small sample size (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200981), and lack of SPSM\u2010specific data limit generalizability, necessitating multi\u2010center studies with comprehensive SPSM characterization for validation.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.71844","type":"journal-article","created":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T03:39:46Z","timestamp":1776829186000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Characteristics and Prognostic Prediction of Secondary Solid Malignancies in Patients With Diffuse Large B\u2010Cell Lymphoma and Follicular Lymphoma"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-3425-2324","authenticated-orcid":false,"given":"Lulu","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Medical Oncology Sun Yat\u2010Sen University Cancer Center  Guangzhou Guangdong China"},{"name":"State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer Sun Yat\u2010Sen University Cancer Center  Guangzhou China"},{"name":"Collaborative Innovation Center for Cancer Medicine  Guangzhou Guangdong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiahao","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Sun Yat\u2010Sen University Cancer Center  Guangzhou Guangdong China"},{"name":"State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer Sun Yat\u2010Sen University Cancer Center  Guangzhou China"},{"name":"Collaborative Innovation Center for Cancer Medicine  Guangzhou Guangdong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qunli","family":"Xiong","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Sun Yat\u2010Sen University Cancer Center  Guangzhou Guangdong China"},{"name":"State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer Sun Yat\u2010Sen University Cancer Center  Guangzhou China"},{"name":"Collaborative Innovation Center for Cancer Medicine  Guangzhou Guangdong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haimei","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Sun Yat\u2010Sen University Cancer Center  Guangzhou Guangdong China"},{"name":"State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer Sun Yat\u2010Sen University Cancer Center  Guangzhou China"},{"name":"Collaborative Innovation Center for Cancer Medicine  Guangzhou Guangdong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhao","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Sun Yat\u2010Sen University Cancer Center  Guangzhou Guangdong China"},{"name":"State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer Sun Yat\u2010Sen University Cancer Center  Guangzhou China"},{"name":"Collaborative Innovation Center for Cancer Medicine  Guangzhou Guangdong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Sun Yat\u2010Sen University Cancer Center  Guangzhou Guangdong China"},{"name":"State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer Sun Yat\u2010Sen University Cancer Center  Guangzhou China"},{"name":"Collaborative Innovation Center for Cancer Medicine  Guangzhou Guangdong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chengcheng","family":"Guo","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer Sun Yat\u2010Sen University Cancer Center  Guangzhou China"},{"name":"Collaborative Innovation Center for Cancer Medicine  Guangzhou Guangdong China"},{"name":"Department of Neurosurgery\/Neuro\u2010Oncology Sun Yat\u2010Sen University Cancer Center  Guangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"He","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Sun Yat\u2010Sen University Cancer Center  Guangzhou Guangdong China"},{"name":"State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer Sun Yat\u2010Sen University Cancer Center  Guangzhou China"},{"name":"Collaborative Innovation Center for Cancer Medicine  Guangzhou Guangdong China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,4,21]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.modpat.2023.100330"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13045-019-0752-3"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.med.59.060906.220345"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.30164"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41408-019-0237-1"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2010.29.1112"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrclinonc.2013.41"},{"issue":"6","key":"e_1_2_13_9_1","first-page":"2863","article-title":"Trends in the Risk of Second Primary Malignances After 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Incidence of B\u2010Cell Non\u2010Hodgkin Lymphoma and Occurrence of Second Primary Malignancies in South Korea: 10\u2010Year Follow\u2010Up Using the Korean National Health Information Database","volume":"52","author":"Kim J. 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