Rising Incidence of Therapy-Related Blood Cancers Linked to Advances in Breast Cancer Survivorship in Japan

New study finds therapy-related AML cases doubled in 30 years. Breast cancer survivors show increased risk of secondary blood cancer from chemo and radiation.

By: AXL Media

Published: Apr 6, 2026, 8:49 AM EDT

Source: Information for this report was sourced from Wiley

The Growing Challenge of Secondary Malignancies in Cancer Survivors

As global cancer survival rates improve, a secondary health crisis is emerging in the form of therapy-related acute myeloid leukemia, or tAML. This aggressive malignancy of the blood and bone marrow develops as a direct complication of treatments used to combat a primary cancer, such as chemotherapy or radiation. According to a new population-based study published in the journal CANCER, these lifesaving interventions can inadvertently cause DNA damage that triggers a later, often more aggressive, blood cancer. The research suggests that as the population of cancer survivors grows, so does the clinical frequency of these treatment-induced complications, requiring a new focus on long-term oncological monitoring.

Quantifying the Statistical Surge of tAML in Osaka

To evaluate the changing landscape of secondary cancers, investigators from the Osaka International Cancer Institute analyzed three decades of data from the Osaka Cancer Registry spanning 1990 to 2020. Out of nearly 10,000 patients diagnosed with acute myeloid leukemia, 6.5% were identified as having the therapy-related variant. The data shows a stark upward trend: the annual incidence of tAML rose from 0.13 per 100,000 people in 1990 to 0.36 per 100,000 by 2020. This indicates that the proportion of tAML cases within the broader AML category has almost doubled over the study period, signaling a significant shift in the epidemiology of blood-related cancers.

Shifting Distributions Among Primary Cancer Demographics

The study highlights a notable change in which types of primary cancer treatment most frequently lead to tAML. Historically, other forms of blood cancer were the most common precursors, accounting for 23.1% of cases in the study. However, the distribution has shifted significantly over time, with a prominent increase in tAML following breast cancer treatment, which now represents 14.6% of the cases. Conversely, the researchers noted a decrease in tAML cases originating from gastric cancer therapies. This evolving distribution reflects both the changing incidence of primary cancers in Japan and the evolving intensity of the pharmacological and radiological regimens used to treat them.