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Adoption of targeted-immunotherapeutics since 2011, may alter the risk of CH progression to tMDS\/AML. To study this, we evaluated risk of tMDS and tAML in 667 588\u2009\u2265\u20091-year survivors of non-small cell lung cancer (NSCLC), renal cell carcinoma (RCC), melanoma and multiple-myeloma (MM) diagnosed during: 2000\u20132005, 2006\u20132010 and 2011\u20132016. The risk of tMDS increased significantly after NSCLC across all time periods (P<jats:sub>trend<\/jats:sub>\u2009=\u20090.002) while tAML risk decreased from 2006\u20132010 to 2011\u20132016, coinciding with increasing use of non-chemotherapeutic agents. tAML risk after RCC decreased (P<jats:sub>trend<\/jats:sub>\u2009=\u20090.007) whereas tMDS risk did not significantly change over time. After melanoma, tMDS and tAML risks were similar to the general population. tMDS and tAML risk after MM increased from the first to second time-period, however, only risk of tMDS decreased during last period. We report diverging trends in the risk of tAML and tMDS after adoption of modern cancer therapies for specific cancers. It is imperative to further explore impact of contemporary treatment strategies on clonal evolution. Modern treatments via their discrete mechanism of actions on pre-existing CH may alter the risk of subsequent tMDS and tAML<jats:bold>.<\/jats:bold><\/jats:p>","DOI":"10.1038\/s41598-021-02497-4","type":"journal-article","created":{"date-parts":[[2021,12,2]],"date-time":"2021-12-02T11:03:04Z","timestamp":1638442984000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Emerging trends of therapy related myeloid neoplasms following modern cancer therapeutics in the United States"],"prefix":"10.1038","volume":"11","author":[{"given":"Abhay","family":"Singh","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megan M.","family":"Herr","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth A.","family":"Griffiths","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda","family":"Przespolewski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark G.","family":"Faber","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chebli","family":"Mrad","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eunice S.","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theresa","family":"Hahn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Swapna","family":"Thota","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,12,2]]},"reference":[{"issue":"11","key":"2497_CR1","doi-asserted-by":"publisher","first-page":"2020","DOI":"10.1158\/1055-9965.EPI-06-0414","volume":"15","author":"LB Travis","year":"2006","unstructured":"Travis, L. 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Receives honoraria from AbbVie, Inc., Boston Biomedical, and Novartis Pharmaceuticals Corporation; receives grant\/research support (to Roswell Park Cancer Institute) from Astex Pharmaceuticals, Celgene Corporation\/Bristol-Meyers Squibb and Genentech, Inc.\nE.W.\u2014Serves on advisory board for Abbvie, Astellas, BMS\/Celgene, Genentech, Jazz, Kite Pharmaceuticals, Macrogenics, Pfizer, PTC Therapeutics, Stemline, Takeda, BMS (Celgene). \nSpeaker role: Stemline, Pfizer, Dava Oncology. Data monitoring committees: Abbvie, Rafael Pharmaceuticals. Other authors disclose no conflicts of interest.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"23284"}}