Risk factors for development of a second lymphoid malignancy in patients with chronic lymphocytic leukaemia

Maddocks-Christianson, Kami; Slager, Susan L.; Zent, Clive S.; Reinalda, Megan S.; Call, Timothy G.; Habermann, Thomas M.; Bowen, Deborah A.; Hoyer, James D.; Schwager, Susan M.; Jelinek, Diane F.; Kay, Neil E.; Shanafelt, Tait D.

doi:10.1111/j.1365-2141.2007.06801.x

Cited by 76 publications

(58 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Patients with CLL are predisposed to the development of a second malignancies due to their impaired immune system and/or the use of chemotherapy (27). Treatment-induced acute leukemia may also occur in a small percentage of patients with CLL (28). However, the concurrence of CLL and CML in the same patient is extremely rare, even in Western countries.…”

Section: Discussionmentioning

confidence: 99%

Dasatinib-responsive Chronic Lymphocytic Leukemia in a Patient Treated for Coexisting Chronic Myeloid Leukemia

et al. 2013

View full text Add to dashboard Cite

We herein present a case of concurrent chronic myeloid leukemia (CML) and chronic lymphocytic leukemia (CLL). Two different clones, a Philadelphia (Ph) clone and a CLL clone with a 13q deletion, were identified using fluorescent in situ hybridization. Dasatinib was administered to inhibit Bcr-Abl and Lyn kinase. The patient exhibited a molecular response for CML and a partial response for CLL. To our knowledge, this is the first report to describe the occurrence of a gradual increase in the Bcr-Abl transcript level prior to the diagnosis of Ph-positive CML in an individual with CLL who was successfully treated with dasatinib as the first-line therapy.

show abstract

Section: Discussionmentioning

confidence: 99%

Dasatinib-responsive Chronic Lymphocytic Leukemia in a Patient Treated for Coexisting Chronic Myeloid Leukemia

et al. 2013

View full text Add to dashboard Cite

show abstract

“…Diagnosis of RS requires a mandatory histologic proof, in the absence of which RS can only be clinically suspected, but not documented [3]. Transformation of CLL to DLBCL should also be kept apart from prolymphocytic transformation, as well as from a miscellanea of other lymphoid malignancies that may develop with increased frequency in CLL patients [4,5].…”

Section: General Conceptsmentioning

confidence: 99%

Richter syndrome: molecular insights and clinical perspectives

Rossi

Gaïdano

2009

Hematological Oncology

108

View full text Add to dashboard Cite

Richter syndrome (RS) represents the clinico-pathologic transformation of chronic lymphocytic leukaemia (CLL) to an aggressive lymphoma, most commonly diffuse large B-cell lymphoma (DLBCL). The clinical definition of RS is heterogeneous, and encompasses at least two biologically different conditions: (i) CLL transformation to a clonally related DLBCL, that accounts for the majority of cases; (ii) development of a DLBCL unrelated to the CLL clone. In clonally related RS, the pathogenetic link between the CLL and the DLBCL phases is substantiated by the acquisition of novel molecular lesions at the time of clinico-pathologic transformation. RS is not a rare event in the natural history of CLL, since the cumulative incidence of RS at 10 years exceeds 10%. Prompt recognition of RS is known to be clinically useful, and may be favoured by close monitoring of CLL patients harbouring clinical and/or biological risk factors of RS development. Conventional risk factors that are independent predictors of RS development at the time of CLL diagnosis include: (i) expression of CD38; (ii) absence of del13q14 and (iii) lymph node size 3 cm. Other risk factors of RS development include CD38 genotype and usage of specific immunoglobulin variable genes. The molecular pathogenesis of RS has been elucidated to a certain extent. Acquisition of TP53 mutations and/or 17p13 deletion is a frequent molecular event in RS, as it is in other types of transformation from indolent to aggressive B-cell malignancies. Additional molecular alterations are being revealed by genome wide studies. Once that transformation has occurred, RS prognosis may be predicted by the RS score, based on performance status, LDH, platelet count, tumour size and number of prior therapies. Depending on patient's age and RS score, the therapeutic options for RS may range from conventional immunochemotherapy to allogeneic bone marrow transplantation.

show abstract

“…[26][27][28] The clinical characteristics and outcomes of younger (≤55 years) patients with chronic lymphocytic leukemia in the era of modern prognostic biomarkers and chemoimmunotherapy are not well understood. Baseline characteristics and outcomes of patients with chronic lymphocytic leukemia ≤55 years who were seen at the Mayo Clinic between January 1995 and April 2012 were compared with those of patients >55 years.…”

Section: Patientsmentioning

confidence: 99%

Chronic lymphocytic leukemia in young (<= 55 years) patients: a comprehensive analysis of prognostic factors and outcomes

et al. 2013

View full text Add to dashboard Cite

ABSTRACTto evaluate the experience of CLL patients who were ≤55 years of age at the time of diagnosis. The threshold of ≤55 years was selected to classify age based on a similar cutoff used to define young CLL patients in historical studies. 5,7,29,30 Patients diagnosed with CLL between January 1995 and April 2012 and who fulfilled the 1996 criteria for CLL 31 and/or the World Health Organization (WHO) criteria for small lymphocytic lymphoma 32 were included in this analysis. Rai stage was ascertained within 12 months of the initial diagnosis. Since FISH results can change during the course of disease or after treatment, 33 only pre-treatment FISH results were used in this study. To adjust for potential referral bias, we compared the characteristics of patients who resided within 120 miles of the Mayo Clinic (excluding the twin cities of Minneapolis and St. Paul) to those who resided >120 milesaway. 34,35 The clinical characteristics and outcomes of CLL patients ≤55 years old were compared to those of CLL patients >55 years old. To further explore associations with patients with young onset CLL, those ≤aged 55 years were also divided into three groups based on their age at diagnosis: (i) ≤45 years, (ii) 46-50 years, and (iii) 51-55 years. The overall survival of patients ≤55 years old was also compared to that of the age-and sex-matched normal population of the state of Minnesota. The Mayo Clinic Institutional Review Board approved this study. Statistical analysisPatients' characteristics are summarized using medians and ranges for continuous variables and frequencies (percentages) for categorical variables. Overall survival was defined as time from diagnosis to date of death due to any cause or last follow-up time, whichever occurred first. Time to first treatment was defined as the time between the date of diagnosis and the date of initiation of treatment or date of last follow-up at which the patient was known to be untreated. Since the indications for treatment under both the 1996 31 and 2008 36 consensus criteria are identical, the indications to initiate treatment were consistent throughout the entire study interval. Expected survival was calculated using the cohort (Hakulinen) method 37 with estimates based on the age-and sexmatched Minnesota population.38 P values <0.05 were considered statistically significant. All statistical analyses were conducted using the SAS 9.2 software package (SAS Institute, Cary, NC, USA). More details on the methods and statistical analysis can be found in the Online Supplementary Appendix. Results Baseline characteristics of patients ≤ 55 years of age relative to those >55 years oldBetween January 1, 1995 and April 9, 2012, 844 patients ≤55 years old (median age, 50 years) with CLL were seen at the Mayo Clinic. A comparison of the baseline characteristics and prognostic profile of these patients relative to the 2324 CLL patients >55 years old (median age, 67 years) seen at the Mayo Clinic during the same time period is shown in Table 1. When compared to patients >55 years ol...

show abstract

Risk factors for development of a second lymphoid malignancy in patients with chronic lymphocytic leukaemia

Cited by 76 publications

References 37 publications

Dasatinib-responsive Chronic Lymphocytic Leukemia in a Patient Treated for Coexisting Chronic Myeloid Leukemia

Dasatinib-responsive Chronic Lymphocytic Leukemia in a Patient Treated for Coexisting Chronic Myeloid Leukemia

Richter syndrome: molecular insights and clinical perspectives

Chronic lymphocytic leukemia in young (<= 55 years) patients: a comprehensive analysis of prognostic factors and outcomes

Contact Info

Product

Resources

About