2nd Cancers in CLL Patients Treated with Chlorambucil Maintenance Therapy

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Leuk Lymphoma. 2006 Nov;47(11):2314-2320.

Incidence of second neoplasia in patients with B-cell chronic

lymphocytic leukemia treated with chlorambucil maintenance

chemotherapy.

Callea V, Brugiatelli M, Stelitano C, Gentile M, Nobile F, Morabito

F.

Hematology Unit, Azienda Ospedaliera Bianchi-Melacrino-Morelli,

Reggio Calabria, Italy.

The aim of this retrospective study was to examine the impact of

prolonged chlorambucil (CLB) therapy on the development of second

neoplasia (SN) in 389 patients with B-CLL, comparing untreated cases

with those receiving CLB as induction plus maintenance therapy.

Fifty-nine SN cases were observed (15.1%) at a median follow-up of

79 months. SN occurrence was significantly related to Binet stage.

No difference was detected between untreated and CLB treated cases

either in terms of SN incidence (12.2% vs 18.1%) nor in the median

follow-up (81 vs 79.1 months). Moreover, SN-free survival was not

different between these two groups.

Four out of 13 CLB treated patients (30.8%) developed s-MDS after a

subsequent treatment with fludarabine plus cyclophosphamide (F + C).

In conclusion, SN development is dependent on the length of follow-

up rather than on therapy duration. F + C should be administered

with caution after prolonged CLB therapy.

PMID: 17107903 [PubMed - as supplied by publisher]