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Risk factors for development of a second lymphoid malignancy in patients with chronic lymphocytic leukaemia
Author(s) -
MaddocksChristianson Kami,
Slager Susan L.,
Zent Clive S.,
Reinalda Megan,
Call Timothy G.,
Habermann Thomas M.,
Bowen Deborah A.,
Hoyer James D.,
Schwager Susan,
Jelinek Diane F.,
Kay Neil E.,
Shanafelt Tait D.
Publication year - 2007
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.2007.06801.x
Subject(s) - medicine , chronic lymphocytic leukemia , lymphoma , gastroenterology , malignancy , cohort , risk factor , epidemiology , cd38 , leukemia , immunology , oncology , stem cell , biology , cd34 , genetics
Summary Previous studies suggested that patients with chronic lymphocytic leukaemia (CLL) are at a three‐ to fivefold increased risk of developing a second lymphoproliferative disorder (LPD). This observational cohort study used the Mayo Clinic CLL Database to identify factors associated with developing a second LPD. A second LPD was identified in 26 (2·7%) of 962 CLL patients during a median follow‐up of 3·3 years. Diffuse large B‐cell lymphoma was the most common subtype of secondary LPD (12 of 26 cases). Patients previously treated for CLL had a trend toward higher prevalence of second LPD (4%) compared with previously untreated patients (2%; P = 0·053). More strikingly, patients treated with purine nucleoside analogues (PNA) had a significantly increased risk of subsequent second LPD (5·2%) compared with patients who had not received PNA (1·9%; P = 0·008). No statistically significant association was observed between risk of second LPD and other CLL characteristics (ZAP‐70, CD38, IgV H mutation status or cytogenetic abnormalities). In this series, prior treatments with PNA or anthracyclines were the only significant factors associated with risk of developing a second LPD in patients with CLL. Physicians should strictly adhere to established criteria to initiate treatment for CLL patients who are not participating in clinical trials.