Second Myeloid Malignancies in a Large Cohort of Patients With Chronic Lymphocytic Leukemia: A Single Institution Experience

Chávez, Julio C.; Dalia, Samir; Sandoval-Sus, José; Kharfan‐Dabaja, Mohamed A.; Al-Ali, Najla; Komrokji, Rami; Padron, Eric; Corrales-Yepez, Gabriela; Rock-Klotz, Jennifer; Pinilla‐Ibarz, Javier

doi:10.1016/j.clml.2015.03.013

Cited by 7 publications

(4 citation statements)

References 24 publications

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“…A multivariate analysis revealed increased risk of SHM in CLL patients with male sex, younger age at diagnosis, and exposure to chemotherapy, consistent with prior studies 13,16,21 . In alignment with prior studies, we noted development of SHM significantly reduces OS in CLL patients (OS: 99 vs. 127 months) 11,12,29 . Among myeloid SHM, CML (95 months) had the best while de‐novo AML (63 months) had the poorest median OS after CLL diagnosis, a finding consistent with prior studies 12,29 …”

Section: Discussionsupporting

confidence: 88%

“…In alignment with prior studies, we noted development of SHM significantly reduces OS in CLL patients (OS: 99 vs. 127 months) 11,12,29 . Among myeloid SHM, CML (95 months) had the best while de‐novo AML (63 months) had the poorest median OS after CLL diagnosis, a finding consistent with prior studies 12,29 …”

Section: Discussionsupporting

confidence: 88%

“…11,12,29 Among myeloid SHM, CML (95 months) had the best while de-novo AML (63 months) had the poorest median OS after CLL diagnosis, a finding consistent with prior studies. 12,29 The main strengths of our study are a) large sample size of CLL…”

Section: Discussionsupporting

confidence: 87%

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A population level analysis of second hematological malignancies in chronic lymphocytic leukemia/small lymphocytic lymphoma survivors in the era of targeted therapies

Mishra

Dima

Kumar

et al. 2023

Hematological Oncology

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With improvement in survival after chronic lymphocytic leukemia (CLL) diagnosis, the real‐world burden of second hematological malignancies (SHM) has not been comprehensively assessed in recent era. We analyzed risk, incidence, and outcomes of SHM in CLL patients between 2000 and 2019 using SEER database. CLL patients had greater risk for hematological malignancies than general population [SIR, standardized incidence ratio (95% CI):2.58 (2.46–2.70); p < 0.05]. The risk for subsequent lymphoma increased by 1.75 folds in 2015–2019 compared to 2000–2004. The duration, after CLL diagnosis, of maximum risk for SHM decreased as 60–119 months for time‐period 2000–2004, 6–11 months for 2005–2009 to 2–5 months for 2010–2014 and 2015–2019. Incidence of SHM was 2.5% in CLL survivors (1736/70,346) with lymphoid SHM being more common than myeloid SHM, and DLBCL being the most common pathology (n = 610, 35% of all SHM). Male sex, age ≤65 years at CLL diagnosis, and chemotherapy treatment were associated with higher risk for SHM. The median gap between CLL and SHM diagnoses was 46 months. The median survival for de‐novo‐AML, t‐MN, CML, and aggressive NHL was 63, 86, 95, and 96 months respectively. Although SHM remains rare, there is increased risk in recent era, likely due to improved survival in CLL patients, necessitating active surveillance strategies.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 88%

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A population level analysis of second hematological malignancies in chronic lymphocytic leukemia/small lymphocytic lymphoma survivors in the era of targeted therapies

Mishra

Dima

Kumar

et al. 2023

Hematological Oncology

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“… 5 In a large cohort study of CLL patients, 30 out of 1269 cases (2.4%) were found to have developed a secondary bone marrow disorder, most commonly myelodysplastic syndrome/AML, accounting for 76.7% of cases. 6 AML has been reported as the second malignancy in CLL patients, with most cases occurring after exposure to alkylating agents commonly used in CLL treatment. 3 Chlorambucil is a DNA alkylating agent based on nitrogen mustard, and is often used as a first-line treatment for CLL in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

Acute Myeloid Leukemia Secondary to Chronic Lymphocytic Leukemia After Prolonged Chlorambucil Therapy: A Case Report

Wu¹,

Liu²,

Wang³

et al. 2023

PGPM

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Background This study aimed to improve the understanding of acute myeloid leukemia (AML) secondary to chronic lymphocytic leukemia (CLL), and to explore the sequence of occurrence and clonal origin of the two diseases. Case Report We reported a case of a 71-year-old man with a history of CLL. The patient was administrated with chlorambucil for 19 years and was admitted to our hospital due to fever. Then he was subjected with routine blood tests, bone marrow smear examination, flow cytometric immunophenotyping and cytogenetic analysis. A final diagnosis of AML-M2 secondary to CLL with -Y,del(4q),del(5q),-7,add(12p),der(17),der(18),-22,+mar was made. After rejecting the therapy with Azacitidine combined with B-cell lymphoma-2 (Bcl-2) inhibitor, the patient died of pulmonary infection. Conclusion This case highlights the rare occurrence of AML secondary to CLL after prolonged chlorambucil therapy and the poor prognosis of such cases, underscoring the importance of enhanced assessment of these patients.

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Bone Marrow Involvement by More Than One Entity of Hematolymphoid Neoplasm

Zhao

Lagoo

Wang

2020

Practical Lymph Node and Bone Marrow Pathology

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Second Myeloid Malignancies in a Large Cohort of Patients With Chronic Lymphocytic Leukemia: A Single Institution Experience

Cited by 7 publications

References 24 publications

A population level analysis of second hematological malignancies in chronic lymphocytic leukemia/small lymphocytic lymphoma survivors in the era of targeted therapies

A population level analysis of second hematological malignancies in chronic lymphocytic leukemia/small lymphocytic lymphoma survivors in the era of targeted therapies

Acute Myeloid Leukemia Secondary to Chronic Lymphocytic Leukemia After Prolonged Chlorambucil Therapy: A Case Report

Bone Marrow Involvement by More Than One Entity of Hematolymphoid Neoplasm

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