Young Patients With CLL At Risk for Secondary Cancers
Patients with chronic lymphocytic leukemia younger than age 55 are at an increased risk for multiple types of secondary cancers for up to 15 years after diagnosis.
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Patients with chronic lymphocytic leukemia (CLL) younger than age 55 are at an increased risk for multiple types of secondary cancers for up to 15 years after diagnosis, according to a study that will be presented at the 2017 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago.1
Though patients with CLL are known to have an increased risk for secondary cancers, few studies have evaluated this risk among patients younger than 55.
This study analyzed data from 4559 patients aged 15 to 54 diagnosed with CLL between 1973 and 2013 from the Surveillance, Epidemiology, and End Results (SEER) Program. The mean age of CLL diagnosis was 48.8.
Standardized incidence ratios were used to determine cancer risk using observed (O) and expected (E) rates, and confidence intervals were assessed using Poisson distribution.
A secondary solid tumor developed in 498 patients in the cohort (O/E, 1.4) at a mean age of 59.9. Overall, the risk was higher than expected for lip (O/E, 3.1), nonepithelial skin (O/E, 5.4), salivary (O/E, 4.8), mesothelioma (O/E, 4.4), melanoma (O/E, 3.1), lung (O/E, 2.4), and kidney (O/E, 1.7) cancers, but lower than expected risk for uterine cancer (O/E, 0.4).
Among a cohort of 4459 patients with CLL older than age 55, the risk for a secondary cancer was higher than expected for Kaposi sarcoma (O/E, 4.9), nonepithelial skin (O/E, 3.6), salivary (O/E, 2.8), melanoma (O/E, 2.1), nose/ear (O/E, 2.0), lip (O/E, 1.7), soft tissue (O/E), 1.6), lung (O/E, 1.4), kidney (O/E, 1.3), and colon (O/E, 1.2) cancers.
In the younger cohort, the highest risk was observed for Caucasian men was lip cancer, descending colon cancer for African Americans, and ureter cancer for women. The most prevalent cancer among all gender and race groups was of the lung.
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According to the investigators, “patients [younger than] 55 have a unique tumor profile and greater risk of secondary solid tumors compared with patients [older than] 55.”
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- Carter JS, Lee WM, Nathan R, et al. Secondary solid tumors in patients younger than 55 with chronic lymphocytic leukemia (CLL). J Clin Oncol. 2017;35(suppl; abstr 10083).