通过现代治疗，套细胞淋巴瘤（MCL）患者更容易获得长期缓解，从而导致长期幸存者数量不断增加。后续护理包括识别和管理与治疗相关的迟发效应，例如继发性恶性肿瘤 (SM)。我们进行了一项基于人群的研究，以描述 MCL 患者的 SM 负担。所有初次诊断为 MCL、年龄≥18 岁并于 2000 年至 2017 年间在瑞典诊断的患者均被纳入研究，以及最多 10 名单独匹配的人群比较者。随访时间为诊断/匹配后 12 个月，直至死亡、移民或 2019 年 12 月（以先发生者为准）。使用 Anderson-Gill 方法（考虑重复事件）估计患者和比较者中的 SM 率，并以风险比 (HR) 和 95% 置信区间 (CI) 的形式呈现，并针对诊断时的年龄、日历年、性别和总体而言，对 1 452 名患者和 13 992 名对照者进行了平均 6.6 年的随访。在患者中，230 名（16%）患者至少出现一种 SM，观察到 264 名 SM。相对于对照组，患者的 SM 发生率较高，HRadj= 1.6 (95%CI:1.4-1.8)，并且在所有主要治疗组中观察到较高的发生率：Nordic-MCL2 方案、R-CHOP、R-苯达莫司汀、依鲁替尼、来那度胺和 R-CHOP/阿糖胞苷。与 Nordic-MCL2 相比，R-苯达莫司汀治疗与 SM 风险增加独立相关，HRadj= 2.0 (95% CI:1.3-3.2)。患者中的危险群体是诊断时年龄较高的患者（p < 0.001）、男性（p = 0.006）和有淋巴瘤家族史的患者（p = 0.009）。患者患黑色素瘤、其他皮肤肿瘤以及其他造血系统和淋巴系统恶性肿瘤的风险较高。MCL 幸存者发生 SM 的风险增加，特别是在使用 R-苯达莫司汀治疗时。长期缓解所需的强化治疗是一个问题，需要过渡到具有持续疗效但 SM 风险较低的治疗方案。版权所有 © 2023 作者。由爱思唯尔有限公司出版。保留所有权利。

With modern treatments, mantle cell lymphoma (MCL) patients more frequently experience long-lasting remission resulting in a growing population of long-term survivors. Follow-up care includes identification and management of treatment-related late-effects, such as secondary malignancies (SM). We conducted a population-based study to describe the burden of SM in MCL patients.All patients with a primary diagnosis of MCL, aged ≥ 18 years and diagnosed between 2000 and 2017 in Sweden were included along with up to 10 individually matched population comparators. Follow-up was from twelve months after diagnosis/matching until death, emigration, or December 2019, whichever occurred first. Rates of SM among patients and comparators were estimated using the Anderson-Gill method (accounting for repeated events) and presented as hazard ratios (HR) with 95% confidence intervals (CI) adjusted for age at diagnosis, calendar year, sex, and the number of previous events.Overall, 1 452 patients and 13 992 comparators were followed for 6.6 years on average. Among patients, 230 (16%) developed at least one SM, and 264 SM were observed. Relative to comparators, patients had a higher rate of SM, HRadj= 1.6 (95%CI:1.4-1.8), and higher rates were observed across all primary treatment groups: the Nordic-MCL2 protocol, R-CHOP, R-bendamustine, ibrutinib, lenalidomide, and R-CHOP/Cytarabine. Compared to Nordic-MCL2, treatment with R-bendamustine was independently associated with an increased risk of SM, HRadj= 2.0 (95%CI:1.3-3.2). Risk groups among patients were those with a higher age at diagnosis (p < 0.001), males (p = 0.006), and having a family history of lymphoma (p = 0.009). Patients had preferably higher risk of melanoma, other neoplasms of the skin and other hematopoietic and lymphoid malignancies.MCL survivors have an increased risk of SM, particularly if treated with R-bendamustine. The intensive treatments needed for long-term remissions are a concern, and transition to treatment protocols with sustained efficacy but with a lower risk of SM is needed.Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.