{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:24:38Z","timestamp":1783038278716,"version":"3.54.6"},"reference-count":30,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2024,4,11]],"date-time":"2024-04-11T00:00:00Z","timestamp":1712793600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Concern has emerged about the prevalence of second cancers among patients with hairy cell leukemia (HCL) treated with purine analogs. We investigated 513 patients with HCL treated with cladribine over the last 30 years at 18 Italian centers and calculated their standardized incidence ratios (SIRs). We identified 24 patients with a second cancer diagnosed at a median time from treatment with cladribine of 59.9 months (range: 9.2\u2013169.7 months). All patients with solid neoplasms presented with a limited-stage disease, except four cases of locally advanced cancer; multiple myeloma patients had a smoldering disease, while lymphoma patients had stage Ie and stage IV diseases. Response to therapy was complete in 19 cases; 1 patient is still receiving treatment for a relapsing bladder disease, while 2 patients progressed during treatment and died. These two patients died from unrelated causes: one from infection and one due to surgery complications. The median OS from HCL was 98.5 months (range: 38.4\u2013409.2 months), while the median OS from second cancer was 27.6 months (range: 1\u2013117.8 months). The SIR was 0.86 (95% CI: 0.54\u20131.30) for males and 1.13 (95% CI: 0.36\u20132.73) for females: no statistically significant differences were highlighted. We were not able to demonstrate an excess of second cancer or a significant association with the specific studied neoplasm.<\/jats:p>","DOI":"10.3390\/cancers16081475","type":"journal-article","created":{"date-parts":[[2024,4,12]],"date-time":"2024-04-12T03:34:37Z","timestamp":1712892877000},"page":"1475","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Second Neoplasms in Italian Patients with Hairy Cell Leukemia after Treatment with Cladribine: A Multicenter Investigation and Literature Review"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5661-2338","authenticated-orcid":false,"given":"Marianna","family":"Criscuolo","sequence":"first","affiliation":[{"name":"Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1392-9874","authenticated-orcid":false,"given":"Maria Elena","family":"Tosti","sequence":"additional","affiliation":[{"name":"Istituto Superiore Sanit\u00e0, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5633-7313","authenticated-orcid":false,"given":"Alessandro","family":"Broccoli","sequence":"additional","affiliation":[{"name":"IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia \u201cSer\u00e0gnoli\u201d, 40138 Bologna, Italy"},{"name":"Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale Universit\u00e0 di Bologna, 40126 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7304-1629","authenticated-orcid":false,"given":"Marzia","family":"Varettoni","sequence":"additional","affiliation":[{"name":"Divisione di Ematologia, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessio Maria Edoardo","family":"Maraglino","sequence":"additional","affiliation":[{"name":"Oncohematology Division, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella","family":"Anastasia","sequence":"additional","affiliation":[{"name":"Department of Hematology, ASST Spedali Civili, 25123 Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Cantonetti","sequence":"additional","affiliation":[{"name":"Dipartimento di Oncoematologia Policlinico Tor Vergata, Universit\u00e0 Tor Vergata, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1222-6149","authenticated-orcid":false,"given":"Livio","family":"Trentin","sequence":"additional","affiliation":[{"name":"Division of Haematology and Clinical Immunology, University of Padova, 35137 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia","family":"Kovalchuk","sequence":"additional","affiliation":[{"name":"SOD C Ematologia, AOU Careggi, 50134 Firenze, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorella","family":"Orsucci","sequence":"additional","affiliation":[{"name":"S.C. Ematologia, A.O.U. Citt\u00e0 della Salute e della Scienza di Torino, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Deodato","sequence":"additional","affiliation":[{"name":"Divisione di Ematologia, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelica","family":"Spolzino","sequence":"additional","affiliation":[{"name":"Dipartimento di Medicina e Chirurgia, Universit\u00e0 degli Studi di Parma, 43125 Parma, Italy"},{"name":"Oncoematologia, Istituto Oncologico Veneto IOV-IRCSS, 31033 Castelfranco Veneto, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Volpetti","sequence":"additional","affiliation":[{"name":"Clinica Ematologia, Azienda Sanitaria Universitaria Integrata, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ombretta","family":"Annibali","sequence":"additional","affiliation":[{"name":"Hematology and Stem Cell Transplantation Unit, Campus Bio-Medico University, 00128 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio","family":"Storti","sequence":"additional","affiliation":[{"name":"UOC Oncoematologia Fondazione di Ricerca e Cura Giovanni Paolo II, Campobasso\u2014Universit\u00e0 Cattolica del Sacro Cuore, 86100 Campobasso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caterina","family":"Stelitano","sequence":"additional","affiliation":[{"name":"Divisione di Ematologia, Azienda Ospedaliera \u201cBianchi Melacrino Morelli\u201d, 89125 Reggio Calabria, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6353-2272","authenticated-orcid":false,"given":"Francesco","family":"Marchesi","sequence":"additional","affiliation":[{"name":"Haematology and Stem Cell Transplantation Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"Mor\u00e8","sequence":"additional","affiliation":[{"name":"Clinica di Ematologia, AOU delle Marche, 60126 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luana","family":"Fianchi","sequence":"additional","affiliation":[{"name":"Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brunangelo","family":"Falini","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, Institute of Hematology and Center for Hemato-Oncology Research, University of Perugia, Santa Maria della Misericordia Hospital, 06123 Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7429-8004","authenticated-orcid":false,"given":"Alessandro","family":"Pulsoni","sequence":"additional","affiliation":[{"name":"Divisione di Ematologia, Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Tiacci","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, Institute of Hematology and Center for Hemato-Oncology Research, University of Perugia, Santa Maria della Misericordia Hospital, 06123 Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2112-2651","authenticated-orcid":false,"given":"Pier Luigi","family":"Zinzani","sequence":"additional","affiliation":[{"name":"IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia \u201cSer\u00e0gnoli\u201d, 40138 Bologna, Italy"},{"name":"Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale Universit\u00e0 di Bologna, 40126 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8287-928X","authenticated-orcid":false,"given":"Livio","family":"Pagano","sequence":"additional","affiliation":[{"name":"Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,4,11]]},"reference":[{"key":"ref_1","unstructured":"Swerdlow, S.H., Campo, E., Harris, N.L., Jaffe, E.S., Pileri, S., Stein, H., Thiele, J., and Vardiman, J.W. (2008). 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Res."}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/16\/8\/1475\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:26:43Z","timestamp":1760106403000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/16\/8\/1475"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,11]]},"references-count":30,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2024,4]]}},"alternative-id":["cancers16081475"],"URL":"https:\/\/doi.org\/10.3390\/cancers16081475","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,11]]}}}