TY - JOUR
T1 - Second cancers in patients with chronic lymphocytic leukemia who received frontline fludarabine, cyclophosphamide and rituximab therapy
T2 - Distribution and clinical outcomes
AU - Benjamini, Ohad
AU - Jain, Preetesh
AU - Trinh, Long
AU - Qiao, Wei
AU - Strom, Sara S
AU - Lerner, Susan
AU - Wang, Xuemei
AU - Burger, Jan
AU - Ferrajoli, Alessandra
AU - Kantarjian, Hagop
AU - O'Brien, Susan
AU - Wierda, William
AU - Estrov, Zeev
AU - Keating, Michael
N1 - Publisher Copyright:
© 2014 Informa UK, Ltd.
PY - 2015/6/1
Y1 - 2015/6/1
N2 - Patients with chronic lymphocytic leukemia (CLL) are known to have an increased incidence of second cancers, but the contribution of commonly used frontline therapies to the incidence of second cancers is unclear. We report on the characteristics, incidence, outcomes and factors associated with second cancers in 234 patients receiving fludarabine, cyclophosphamide and rituximab (FCR) based regimens in the frontline setting. The risk of second cancers was 2.38 times higher than the expected risk in the general population. Ninety-three patients (40%) had other cancers before and 66 patients (28%) after FCR. Rates of therapy related acute myeloid leukemia/myelodysplastic syndrome (t-AML/MDS) (5.1%) and Richter transformation (RT) (9%) were high, while solid tumors were not increased. Overall survival of patients with second cancers after frontline FCR was shorter (median of 4.5 years) compared to patients with and without prior cancers. Second cancer risk after frontline FCR is mainly due to high rates of t-AML/MDS and RT, and as speculated the survival of affected patients is shorter.
AB - Patients with chronic lymphocytic leukemia (CLL) are known to have an increased incidence of second cancers, but the contribution of commonly used frontline therapies to the incidence of second cancers is unclear. We report on the characteristics, incidence, outcomes and factors associated with second cancers in 234 patients receiving fludarabine, cyclophosphamide and rituximab (FCR) based regimens in the frontline setting. The risk of second cancers was 2.38 times higher than the expected risk in the general population. Ninety-three patients (40%) had other cancers before and 66 patients (28%) after FCR. Rates of therapy related acute myeloid leukemia/myelodysplastic syndrome (t-AML/MDS) (5.1%) and Richter transformation (RT) (9%) were high, while solid tumors were not increased. Overall survival of patients with second cancers after frontline FCR was shorter (median of 4.5 years) compared to patients with and without prior cancers. Second cancer risk after frontline FCR is mainly due to high rates of t-AML/MDS and RT, and as speculated the survival of affected patients is shorter.
KW - Chemotherapeutic approaches
KW - Lymphoid leukemia
KW - Pharmacotherapeutics
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U2 - 10.3109/10428194.2014.957203
DO - 10.3109/10428194.2014.957203
M3 - Article
C2 - 25308294
AN - SCOPUS:84932166175
SN - 1042-8194
VL - 56
SP - 1643
EP - 1650
JO - Leukemia and Lymphoma
JF - Leukemia and Lymphoma
IS - 6
ER -