Second malignancies and Richter's syndrome in patients with chronic lymphocytic leukaemia treated with cladribine
| Autor: | T. Robak, J.Z. Blonski, J. Gora-Tybor, M. Kasznicki, L. Konopka, B. Ceglarek, M. Komarnicki, K. Lewandowski, A. Hellmann, A. Moskwa, A. Dmoszyńska, B. Sokołowska, A. Dwilewicz-Trojaczek, A. Tomaszewska, K. Sułek, M. Całbecka |
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| Rok vydání: | 2004 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Lung Neoplasms medicine.drug_class Chronic lymphocytic leukemia Antineoplastic Agents Gastroenterology Antimetabolite Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Lung cancer Cladribine Cyclophosphamide Aged Retrospective Studies Aged 80 and over Lung Lymphocytic leukaemia business.industry Respiratory disease Neoplasms Second Primary Syndrome Middle Aged medicine.disease Leukemia Lymphocytic Chronic B-Cell Surgery medicine.anatomical_structure Oncology Doxorubicin Vincristine Prednisone Female Complication business medicine.drug |
| Zdroj: | European journal of cancer (Oxford, England : 1990). 40(3) |
| ISSN: | 0959-8049 |
| Popis: | The increased frequency of second malignancies in chronic lymphocytic leukaemia (CLL) is well known. Moreover, antineoplastic therapy additionally increases the risk of secondary cancers. In this study, we analysed whether treatment with cladribine (2-chlorodeoxyadenosine, 2-CdA) during the course of CLL had an impact on the subsequent occurrence of either secondary solid tumours or Richter's syndrome. There were 1487 eligible patients, 251 treated with 2-CdA alone, 913 treated with alkylating agents (AA)-based regimens alone and 323 treated with both 2-CdA and AA. Median time from the start of CLL treatment to the diagnosis of secondary malignancy was 1.9 years (0.5-5.1 years) for the 2-CdA group, 1.8 years (0.3-7.9 years) for the AA group and 3.9 years (0.3-8.4 years) for the 2-CdA+AA group. A total of 68 malignancies were reported in 65 patients. Ten events were non-melanotic skin cancers and were excluded from the analysis, leaving 58 events in 58 patients. In the group of patients treated with 2-CdA alone, there were 15 (6.0%) cases, in the group of patients treated with AA alone there were 26 (2.8%) cases, and in the group treated with 2-CdA+AA there were 17 (5.3%) cases of secondary malignancies. The differences between the frequency of secondary malignancies in the 2-CdA and 2-CdA+AA versus AA alone groups were not significant (P=0.05 and P=0.06, respectively). Only lung cancers occurred significantly more frequently in the 2-CdA (2.8%) and 2-CdA+AA (2.2%) treated groups compared with the AA patients (0.3%) (P0.001 and P0.01, respectively). In conclusion, 2-CdA in CLL patients does not seem to increase the risk of secondary malignancies except for lung cancers. However, further studies are necessary to establish the real risk of lung cancer in CLL patients treated with 2-CdA. |
| Databáze: | OpenAIRE |
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