Effect of first-line treatment on second primary malignancies and Richter’s transformation in patients with CLL View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2016-10

AUTHORS

C Maurer, P Langerbeins, J Bahlo, P Cramer, A M Fink, N Pflug, A Engelke, J von Tresckow, G Kovacs, S Stilgenbauer, C-M Wendtner, L Müller, M Ritgen, T Seiler, K Fischer, M Hallek, B Eichhorst

ABSTRACT

This study aimed to assess the frequency of and the contributing factors for second primary malignancies (SPMs) and Richter's transformations (RTs) following first-line treatment of chronic lymphocytic leukemia within four phase II/III trials of the GCLLSG evaluating fludarabine (F) vs F+cyclophosphamide (FC), chlorambucil vs F, FC without or with rituximab, and bendamustine+R (BR). Among 1458 patients, 239 (16.4%) experienced either an SPM (N=191) or a RT (N=75). Solid tumors (N=115; 43.2% of all second neoplasias) appeared most frequently, followed by RTs (N=75; 28.2%). Patients showed a 1.23-fold increased risk of solid tumors in comparison to the age-matched general population from the German cancer registry. Age>65 (hazard ratio (HR) 2.1; P<0.001), male sex (HR 1.7; P=0.01), co-morbidities (HR 1.6; P=0.01) and number of subsequent treatments⩾1 (HR 12.1; P<0.001) showed an independent adverse prognostic impact on SPM-free survival. Serum thymidine kinase>10 U/l at trial enrollment (HR 3.9; P=0.02), non-response to first-line treatment (HR 3.6; P<0.001) and number of subsequent treatments⩾1 (HR 30.2; P<0.001) were independently associated with increased risk for RT. More... »

PAGES

2019

Identifiers

URI

http://scigraph.springernature.com/pub.10.1038/leu.2016.113

DOI

http://dx.doi.org/10.1038/leu.2016.113

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1035374649

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/27133817


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