Subsequent or concurrent acute leukemia (AL) or myelodysplastic syndrome (MDS) in chronic lymphocytic leukemia (CLL) is associated with poorer outcomes, according to an article published in Leukemia.1
Investigators retrospectively observed 95 CLL patients with AL (n=38) or MDS (n=57) to report their outcomes. Twelve patients were treatment-naïve for CLL, and the median number of treatments received before AL or MDS diagnosis was 2 (0-9) and 1 (0-8), respectively.
In the AL group, 33 had acute myelogenous leukemia (AML), 3 had acute lymphoid leukemia (ALL), one was biphenotypic, and one had extramedullary AML. Twenty-six patients with AML had an adverse karyotype, and immediate risk was observed in 7 patients.
The number of prior CLL regimens or karyotype had no impact on survival, and shorter survival was apparent in patients with CD7 blast expression.
The International Prognostic Scoring System (IPSS) was used in the MDS group; 36 patients possessed an unfavorable karyotype, 12 had a favorable karyotype, 6 were intermediate risk, and 10 patients’ MDS transformed into AML. Higher-risk IPSS, poor-risk karyotypes, and an increased number of prior CLL treatments shortened survival.
The authors concluded that although the occurrence of simultaneous or subsequent AL or MDS in CLL is infrequent, effective therapies are necessary to treat this population and improve outcomes.
- Tambaro FP, Garcia-Manero G, O’Brien SM, et al. Outcomes for patients with chronic lymphocytic leukemia and acute leukemia or myelodysplastic syndrome [published online ahead of print August 20, 2015]. Leukemia. doi: 10.1038/leu.2015.227.