title: Incidence of second neoplasia in patients with B-cell chronic lymphocytic leukemia treated with chlorambucil maintenance chemotherapy.
abstract: 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 neither 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.
authors.affiliation: Hematology Unit, Azienda Ospedaliera Bianchi-Melacrino-Morelli, Reggio Calabria, Italy. calleamd@tin.it
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Callea
authors.forename: Maura
authors.initials: M
authors.lastname: Brugiatelli
authors.forename: Caterina
authors.initials: C
authors.lastname: Stelitano
authors.forename: Massimo
authors.initials: M
authors.lastname: Gentile
authors.forename: Francesco
authors.initials: F
authors.lastname: Nobile
authors.forename: Fortunato
authors.initials: F
authors.lastname: Morabito
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002699:Chlorambucil / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D015994:Incidence; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000150:complications* / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016609:Neoplasms, Second Primary / Q000139:chemically induced / Q000150:complications* / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology; D015996:Survival Rate
chemical_list: D000970:Antineoplastic Agents; D002699:Chlorambucil