CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2020; 41(05): 787-788
DOI: 10.4103/ijmpo.ijmpo_282_20
Letter to Editor

Chronic lymphocytic leukemia and Second Primary Malignancies: A Relationship Revisited

Amarendra Amar
Department of Medical Oncology, Indraprastha Apollo Hospital, New Delhi, India
› Author Affiliations
Financial support and sponsorship Nil.

Sir,

Chronic lymphocytic leukemia (CLL), the most commonly diagnosed leukemia globally, generally affects older persons with median survival being in excess of 10 years.[1] Present-day treatment options achieve good responses, thereby improving long-term survival. However, not widely recognized is the fact that these patients may have rather an increased susceptibility to second primary malignancies (SPMs) among other issues.[2] Indeed, a 20% greater risk of occurrence of any SPM has been found in studies comparing these patients to the U. S. general population. This increased risk has been seen for both solid as well as hematological malignancies.[3] The probable causes for such observation could be genetic susceptibility, common risk factors, CLL-associated immune dysfunction, and possibly the effect of chemotherapy.



Publication History

Received: 06 June 2020

Accepted: 05 October 2020

Article published online:
17 May 2021

© 2020. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

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  • References

  • 1 Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. Cancer J Clin 2018; 68: 7-30
  • 2 Tam CS, Keating MJ. Chemoimmunotherapy of chronic lymphocytic leukemia. Nat Rev Clin Oncol 2010; 7: 521-32
  • 3 Kumar V, Ailawadhi S, Bojanini L, Mehta A, Biswas S, Sher T. et al. Trends in the risk of second primary malignancies among survivors of chronic lymphocytic leukemia. Blood Cancer J 2019; 9: 75
  • 4 Falchi L, Vitale C, Keating MJ, Lerner S, Wang X, Elhor Gbito KY. et al. Incidence and prognostic impact of other cancers in a population of long-term survivors of chronic lymphocytic leukemia. Ann Oncol 2016; 27: 1100-6
  • 5 Tsimberidou AM, Wen S, McLaughlin P, O'Brien S, Wierda WG, Lerner S. et al. Other malignancies in chronic lymphocytic leukemia/small lymphocytic lymphoma. J Clin Oncol 2009; 27: 904-10
  • 6 Forconi F, Moss P. Perturbation of the normal immune system in patients with CLL. Blood 2015; 126: 573-81
  • 7 Benjamini O, Jain P, Trinh L, Qiao W, Strom SS, Lerner S. et al. Second cancers in patients with chronic lymphocytic leukemia who received frontline fludarabine, cyclophosphamide and rituximab therapy: Distribution and clinical outcomes. Leuk Lymphoma 2015; 56: 1643-50
  • 8 Byrd JC, Furman RR, Coutre SE, Burger JA, Blum KA, Coleman M. et al. Three-year follow-up of treatment-naïve and previously treated patients with CLL and SLL receiving single-agent ibrutinib. Blood 2015; 125: 2497-506
  • 9 Byrd JC, O'Brien S, James DF. Ibrutinib in relapsed chronic lymphocytic leukemia. N Engl J Med 2013; 369: 1278-9
  • 10 Bond DA, Huang Y, Fisher JL, Ruppert AS, Owen DH, Bertino EM. et al. Second cancer incidence in CLL patients receiving BTK inhibitors. J Clin Oncol 2019; 37: 15_Suppl, 7511'
  • 11 Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma, Version 4. www.nccn.org. 2020, National Comprehensive Cancer Network. Available from: [Last updated on 2020 Aug 29]