Table 4.
Risk factors for the development of secondary sarcomas: univariate analysis *
| Variable | RR (95% CI) | P value |
|---|---|---|
| Sex | 0.79 (0.5 to 1.2) | .23 |
| Race | ||
| White | 1.0 (referent) | – |
| Black | 0.9 (0.3 to 2.3) | .76 |
| Hispanic | 0.9 (0.4 to 2.3) | .86 |
| Other | 0.3 (0.1 to 1.1) | .08 |
| Age at primary diagnosis, y | ||
| 0–3 | 1.0 (referent) | – |
| 4–10 | 0.7 (0.4 to 1.2) | .20 |
| 11–14 | 0.3 (0.1 to 1.0) | .06 |
| 15–20 | 0.9 (0.4 to 2.0) | .75 |
| Primary cancer diagnosis | ||
| Heme malignancy | 1.0 (referent) | – |
| Neuroblastoma | 0.8 (0.2 to 3.7) | .80 |
| CNS | 2.3 (1.0 to 5.3) | .04 |
| Hodgkin lymphoma | 5.7 (3.0 to 10.9) | <.001 |
| Bone | 5.0 (2.4 to 10.4) | <.001 |
| Kidney | 3.2 (1.4 to 7.2) | <.001 |
| Soft tissue sarcoma | 8.8 (4.6 to 16.8) | <.001 |
| Radiation | 3.4 (1.8 to 6.4) | <.001 |
| Chemotherapy | 0.5 (0.2 to 0.9) | .02 |
| Anthracycline cumulative dose, mg/m2 | ||
| 0 | 1.0 (referent) | – |
| 1–100 | 1.0 (0.2 to 4.0) | .96 |
| 101–300 | 2.3 (1.4 to 4.0) | <.001 |
| >300 | 2.7 (1.7 to 4.5) | <.001 |
| Alkylator score† | ||
| 0 | 1.0 (referent) | – |
| 1 | 1.4 (0.8 to 2.8) | .23 |
| 2 | 3.5 (2.0 to 6.2) | <.001 |
| 3 | 3.9 (2.2 to 7.1) | <.001 |
| Platinum drug score† | ||
| 0 | 1.0 (referent) | – |
| 1 | 2.6 (0.9 to 7.1) | .06 |
| 2 | 1.5 (0.4 to 6.0) | .59 |
| 3 | 1.6 (0.2 to 11.7) | .62 |
| Epipophyllotoxin drug score† | ||
| 0 | 1.0 (referent) | – |
| 1 | 1.6 (0.5 to 4.9) | .45 |
| 2 | 1.6 (0.5 to 4.9) | .44 |
| 3 | 0.5 (0.1 to 3.3) | .45 |
| Stem cell transplant | 0.5 (0.1 to 2.0) | .31 |
| History of other SMN | 2.7 (1.4 to 5.1) | <.001 |
| Family history of cancer | 1.6 (1.1 to 2.3) | <.001 |
| Treatment era | ||
| 1970–1974 | 1.0 (referent) | – |
| 1975–1979 | 0.9 (0.5 to 1.5) | .63 |
| 1980–1986 | 0.8 (0.5 to 1.3) | .34 |
*
RR = relative risk; CI = confidence interval; CNS = central nervous system; SMN = second malignant neoplasm. Boldface values are statistically significant. Chi-square tests were used. All statistical tests were two-sided.
†
For platinum drugs, alkylator drugs, and epiphyllotoxins, each subject was assigned a score of 0, 1, 2, or 3 for each drug, depending on whether the subject received no agent or fell into the lower, middle, or upper third of each distribution, respectively.