{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T22:27:39Z","timestamp":1783463259935,"version":"3.55.0"},"reference-count":34,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T00:00:00Z","timestamp":1772496000000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2026,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Bendamustine\u2010rituximab (BR) is common frontline therapy for indolent B\u2010cell non\u2010Hodgkin lymphomas (iBCL), but its association with secondary primary malignancies (SPM) is unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The authors conducted a population\u2010based study using linked Ontario health care databases. Patients \u226518 years old with untreated iBCL receiving BR (2013\u20132022) were compared to a historical cohort receiving cyclophosphamide\u2010based regimens (rituximab, cyclophosphamide, vincristine, prednisone\/rituximab with cyclophosphamide, doxorubicin, vincristine, and prednisone [R\u2010CVP\/CHOP], 2006\u20132012). Five\u2010year SPM incidence was assessed using cumulative incidence function and competing risk models. Landmark analysis was conducted at 6 months after index date.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 6878 patients (BR, 4611; R\u2010CVP\/CHOP, 2267) were identified; BR recipients were older (65.6 vs. 62.8 years,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a0.001). The 5\u2010year cumulative incidence of SPM was higher with BR versus R\u2010CVP\/CHOP (8.9% vs. 7.2%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.019) as was the SPM rate at 6.4 versus 4.9 per 100,000 person\u2010days (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.006), with higher rates of respiratory tract, male genitourinary, and skin cancers. Myelodysplastic syndrome\/acute myeloid leukemia cases were similar accounting for group size (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a023 vs. 11,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.20). Multivariable analysis showed no significant difference in SPM risk (hazard ratio [HR], 1.13; 95% CI, 0.93\u20131.36,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.22); full versus abbreviated BR was associated with borderline higher SPM risk (cumulative incidence function, 10.7% vs. 7.2%; HR, 1.51,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.06). No difference was seen by cycles for R\u2010CVP\/CHOP. Development of SPM shortened survival (HR, 3.67; 95% CI, 3.15\u20134.29,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although BR patients demonstrated a higher SPM risk at 5 years in univariate models, this finding was not present on multivariable analysis. An increased number of BR cycles was associated with borderline increased SPM risk. These findings require prospective validation and studies examining risk\u2010adapted abbreviation of chemotherapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.70327","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T11:14:08Z","timestamp":1772968448000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Secondary primary malignancies in indolent non\u2010Hodgkin lymphoma patients receiving frontline bendamustine\u2010rituximab"],"prefix":"10.1002","volume":"132","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4472-6535","authenticated-orcid":false,"given":"Gwynivere A.","family":"Davies","sequence":"first","affiliation":[{"name":"Department of Oncology McMaster University  Hamilton Ontario Canada"},{"name":"Hamilton Health Sciences Juravinski Cancer Center  Hamilton Ontario Canada"},{"name":"Escarpment Cancer Research Institute  Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anca","family":"Prica","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Toronto  Toronto Ontario Canada"},{"name":"Department of Medical Oncology and Hematology Princess Margaret Cancer Centre  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zharmaine","family":"Ante","sequence":"additional","affiliation":[{"name":"Cancer Research Program ICES  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ning","family":"Liu","sequence":"additional","affiliation":[{"name":"Cancer Research Program ICES  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory R.","family":"Pond","sequence":"additional","affiliation":[{"name":"Department of Oncology McMaster University  Hamilton Ontario Canada"},{"name":"Escarpment Cancer Research Institute  Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2831-9107","authenticated-orcid":false,"given":"Amaris K.","family":"Balitsky","sequence":"additional","affiliation":[{"name":"Department of Oncology McMaster University  Hamilton Ontario Canada"},{"name":"Hamilton Health Sciences Juravinski Cancer Center  Hamilton Ontario Canada"},{"name":"Escarpment Cancer Research Institute  Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Suleman","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology and Hematology Princess Margaret Cancer Centre  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3436-3849","authenticated-orcid":false,"given":"Lee","family":"Mozessohn","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Toronto  Toronto Ontario Canada"},{"name":"Cancer Research Program ICES  Toronto Ontario Canada"},{"name":"Division of Medical Oncology and Hematology Sunnybrook Odette Cancer Centre  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,3]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2008.18.1495"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/jncimonographs\/lgu013"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(12)61763\u20102"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102013\u201011\u2010531327"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.18.00605"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.76.8960"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bneo.2024.100019"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.18972"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21357"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1614598"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2023011305"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/hon.3128"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/0284186X.2019.1643918"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.25707"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/2040620720914490"},{"key":"e_1_2_9_17_1","first-page":"246","article-title":"Cancer registration in Ontario: a computer approach","volume":"95","author":"Clarke EA","year":"1991","journal-title":"IARC Sci Publ"},{"key":"e_1_2_9_18_1","unstructured":"MathesonF MoloneyG vanIngenT.Ontario marginalization index: frequently asked questions.2021. 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