Second malignancies and Richter's syndrome in patients with chronic lymphocytic leukaemia treated with cladribine

Robak, Tadeusz; Błoński, Jerzy Z.; Góra‐Tybor, Joanna; Kasznicki, Marek; Konopka, L; Ceglarek, B.; Komarnicki, Mieczysław; Lewandowski, Krzysztof; Hellmann, Andrzej; Moskwa, Andrzej; Dmoszyńska, Anna; Sokołowska, Bożena; Dwilewicz-Trojaczek, A.; Tomaszewska, Agnieszka; Sułek, K; Całbecka, Małgorzata

doi:10.1016/j.ejca.2003.09.031

Cited by 63 publications

(39 citation statements)

References 36 publications

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“…31 These agents incorporate themselves into the DNA, leading to DNA damage and interference with repair pathways. [31][32][33][34][35][36] Therefore, it is plausible that antimetabolites might interact synergistically with the proliferative and/or antiapoptotic activity of CSFs to initiate and then facilitate leukemogenesis.…”

Section: Discussionmentioning

confidence: 99%

Use of white blood cell growth factors and risk of acute myeloid leukemia or myelodysplastic syndrome among elderly patients with non‐Hodgkin lymphoma

Gruschkus

Lairson

Dunn

et al. 2010

Cancer

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BACKGROUND. The current study was conducted to evaluate the association between colony-stimulating factor (CSF) use and the risk of developing therapy-related myelodysplastic syndromes or acute myeloid leukemia (t-MDS/ AML) among a large cohort of elderly patients with non-Hodgkin lymphoma (NHL) who were treated with chemotherapy. METHODS. A total of 13,203 NHL patients were identified from the Surveillance, Epidemiology, and End Results-Medicare database who were diagnosed from 1992 through 2002. Patients were followed from their initial chemotherapy date until the date they were diagnosed with t-MDS/AML, death, or last follow-up (October 31, 2006), whichever occurred first. RESULTS. Overall, 40% (n ¼ 5266) of patients received CSF. During the follow-up period (median follow-up, 2.9 years [range, 1-14.7 years]), 272 (5.2%) patients who were treated with CSF developed t-MDS/ AML, compared with 230 (2.9%) patients who did not (P < .0001, log-rank test). The 5-year incidence of t-MDS/AML for patients receiving CSF was 14.1 per 1000 person-years compared with 8.3 per 1000 person-years for patients not receiving CSF. In a multivariable Cox regression analysis adjusted for gender, histology, stage, comorbidities, radiotherapy, and chemotherapy agent, CSF use was found to be independently associated with a 53% increased risk of t-MDS/AML (hazard ratio [HR], 1.53; 95% confidence interval [95% CI], 1.26-1.84). The observed association between CSF use and t-MDS/AML persisted across histologic subgroups (ie, diffuse large B-cell lymphoma, follicular lymphoma, and others). Patients who received both CSF and antimetabolite chemotherapy were found to have a 2.5-fold increased risk of t-MDS/AML (HR, 2.49; 95% CI, 1.91-3.26) compared with patients who received neither agent. CONCLUSIONS. The current study, which to our knowledge is the first large population-based study published to date, demonstrated that the administration of CSF among elderly NHL patients receiving chemotherapy was associated with an increased risk of t-MDS/AML, although the absolute risk was low. Cancer 2010;116:5279-89.

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Section: Discussionmentioning

confidence: 99%

Use of white blood cell growth factors and risk of acute myeloid leukemia or myelodysplastic syndrome among elderly patients with non‐Hodgkin lymphoma

Gruschkus

Lairson

Dunn

et al. 2010

Cancer

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“…A larger proportion of patients in our alemtuzumab study population had advanced disease compared with the historical controls and in contrast to other studies. 8 Whether B-CLL patients in various geographical regions and of different ethnic background could have different risk of developing RS is, to our knowledge, not clear. Most (94%) RS cases in our series were diagnosed as DLBCL, which is consistent with previous reports.…”

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confidence: 96%

Alemtuzumab as first-line therapy for B-cell chronic lymphocytic leukemia: long-term follow-up of clinical effects, infectious complications and risk of Richter transformation

et al. 2006

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“…110 A comparison of purine analog-treated patients to an age-adjusted population from the Surveillance, Epidemiology, and End Results database found a slight increase in observed-to-expected secondary malignancies. However, this finding was more consistent with the known increased incidence associated with lymphoproliferative disorders and not necessarily from purine analog exposure.…”

Section: Secondary Malignancy Riskmentioning

confidence: 99%

Beyond hairy cell: the activity of cladribine in other hematologic malignancies

Sigal

Miller

Schram

et al. 2010

Blood

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Second malignancies and Richter's syndrome in patients with chronic lymphocytic leukaemia treated with cladribine

Cited by 63 publications

References 36 publications

Use of white blood cell growth factors and risk of acute myeloid leukemia or myelodysplastic syndrome among elderly patients with non‐Hodgkin lymphoma

Use of white blood cell growth factors and risk of acute myeloid leukemia or myelodysplastic syndrome among elderly patients with non‐Hodgkin lymphoma

Alemtuzumab as first-line therapy for B-cell chronic lymphocytic leukemia: long-term follow-up of clinical effects, infectious complications and risk of Richter transformation

Beyond hairy cell: the activity of cladribine in other hematologic malignancies

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