Cutaneous T-cell lymphoma is associated with increased risk of lymphoma, melanoma, lung cancer, and bladder cancer: a systematic review and meta-analysis

Bladder Cancer

J Am Acad Dermatol. 2020 Aug 18:S0190-9622(20)32444-0. doi: 10.1016/j.jaad.2020.06.1033. Online ahead of print.


BACKGROUND: Patients with cutaneous T-cell lymphoma (CTCL) are at a higher risk of developing second malignancies. However, rates of incidence vary significantly across studies.

METHODS: A systematic review and meta-analysis of manuscripts published between 1950-2019 was performed to evaluate risk of second malignancies in patients with CTCL.

RESULTS: We identified 10 eligible studies, including 12 patient cohorts, with 5.9-16.8% of patients developing second malignancies. All studies showed a male predominance for patients developing second malignancies. Mean age across the studies ranged from 44.6 to 68.0. Time between the diagnosis of CTCL and second malignancy ranged from 2.1-5.4 years (mean 3.29 years, [95% CI 2.69-5.15]). Meta-analysis revealed a SIR of 2.18 [95% CI 1.43-2.93] for all malignancies. The SIR was 15.25 [7.70-22.79] for Hodgkin lymphoma, 4.96 [3.58-6.33] for non-Hodgkin lymphoma, 1.69 [1.18-2.21] for lung cancer, 1.72 [1.18-2.21] for bladder cancer, and 3.09 [1.77-6.43] for melanoma.

CONCLUSIONS: We find that patients with CTCL are at increased risk of second malignancies, especially Hodgkin and non-Hodgkin lymphoma, lung cancer, bladder cancer, and melanoma. These findings provide evidence of a population at increased risk of malignancy. Early detection may decrease the morbidity burden of second malignancies, thus providing a strong rationale for prospective screening studies.