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Helping patients and practitioners understand and treat an unexpected cancer diagnosis

Barrie, ON - Dr. Rouslan Kotchetkov, RVH Hematologist Oncologist, has observed an increasing number of patients presenting to the Simcoe Muskoka Regional Cancer Program with single hematologic malignancy that were unexpectedly diagnosed with an unrelated, simultaneously occurring blood cancer.


Unfortunately, synchronous dual hematological malignancies (SDHM) are often overlooked, usually only identified as a result of discordant clinical or laboratory findings. As such, clinical practice guidelines remain underreported, which can pose significant challenges for practitioners looking to best treat their patients.


Recognizing the need for greater evidence-based awareness about SDHM, Dr. Kotchetkov along with colleagues Dr. Erin Ellison, Dr. Jesse McLean, Dr. Bryn Pressnail, and Dr. Derek Nay, conducted an extensive review of 3,036 patients who presented to RVH with hematologic malignancies in order to provide a comprehensive breakdown of the disease’s characteristics and treatment outcomes.


Of all the charts reviewed, 46 patients were identified as having SDHM, a prevalence of 1.51% among patients diagnosed with any hematological malignancy. Dr. Kotchetkov and colleagues were further able to identify different combinations of SDHM comprised of myeloid and/or lymphoid lineages and provided details of clinical management for each sub-type.


Overall, the study suggests that SDHMs are not uncommon and should be suspected in situations where patients present with unusual or unexpected finding in patients with single hematological. Although the sample size of the population investigated was a limitation of the research, the study’s evidence concluded that greater awareness and further research is warranted in this otherwise under-investigated population. Importantly, the study suggests greater sharing of both patient and physician experiences with SDHM will help others to be understand the disease in the hopes of improving patient outcomes and treatment responses.


The study was published in the journal Hematology in October 2018.


Kotchetkov R, Ellison E, McLean J, Pressnail B, Nay D (2018) Synchronous dual hematological malignancies: new or underreported entity? Hematology. 2018 Oct;23(9):596-599.

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