{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T07:18:32Z","timestamp":1761895112086,"version":"build-2065373602"},"reference-count":36,"publisher":"Wiley","issue":"22","license":[{"start":{"date-parts":[[2010,7,21]],"date-time":"2010-07-21T00:00:00Z","timestamp":1279670400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2010,11,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>BACKGROUND.<\/jats:title><jats:p>The current study was conducted to evaluate the association between colony\u2010stimulating factor (CSF) use and the risk of developing therapy\u2010related myelodysplastic syndromes or acute myeloid leukemia (t\u2010MDS\/AML) among a large cohort of elderly patients with non\u2010Hodgkin lymphoma (NHL) who were treated with chemotherapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS.<\/jats:title><jats:p>A total of 13,203 NHL patients were identified from the Surveillance, Epidemiology, and End Results\u2010Medicare database who were diagnosed from 1992 through 2002. Patients were followed from their initial chemotherapy date until the date they were diagnosed with t\u2010MDS\/AML, death, or last follow\u2010up (October 31, 2006), whichever occurred first.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS.<\/jats:title><jats:p>Overall, 40% (n = 5266) of patients received CSF. During the follow\u2010up period (median follow\u2010up, 2.9 years [range, 1\u201014.7 years]), 272 (5.2%) patients who were treated with CSF developed t\u2010MDS\/AML, compared with 230 (2.9%) patients who did not (<jats:italic>P<\/jats:italic> &lt; .0001, log\u2010rank test). The 5\u2010year incidence of t\u2010MDS\/AML for patients receiving CSF was 14.1 per 1000 person\u2010years compared with 8.3 per 1000 person\u2010years for patients not receiving CSF. In a multivariable Cox regression analysis adjusted for gender, histology, stage, comorbidities, radiotherapy, and chemotherapy agent, CSF use was found to be independently associated with a 53% increased risk of t\u2010MDS\/AML (hazard ratio [HR], 1.53; 95% confidence interval [95% CI], 1.26\u20101.84). The observed association between CSF use and t\u2010MDS\/AML persisted across histologic subgroups (ie, diffuse large B\u2010cell lymphoma, follicular lymphoma, and others). Patients who received both CSF and antimetabolite chemotherapy were found to have a 2.5\u2010fold increased risk of t\u2010MDS\/AML (HR, 2.49; 95% CI, 1.91\u20103.26) compared with patients who received neither agent.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS.<\/jats:title><jats:p>The current study, which to our knowledge is the first large population\u2010based study published to date, demonstrated that the administration of CSF among elderly NHL patients receiving chemotherapy was associated with an increased risk of t\u2010MDS\/AML, although the absolute risk was low. Cancer 2010. \u00a9 2010 American Cancer Society.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.25525","type":"journal-article","created":{"date-parts":[[2010,7,21]],"date-time":"2010-07-21T11:34:55Z","timestamp":1279712095000},"page":"5279-5289","source":"Crossref","is-referenced-by-count":17,"title":["Use of white blood cell growth factors and risk of acute myeloid leukemia or myelodysplastic syndrome among elderly patients with non\u2010Hodgkin lymphoma"],"prefix":"10.1002","volume":"116","author":[{"given":"Stephen K.","family":"Gruschkus","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Lairson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. 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