title: The coexistence of chronic lymphocytic leukemia and myeloproliperative neoplasms: a retrospective multicentric GIMEMA experience.
abstract: Although the coexistence of chronic lymphocytic leukemia (CLL) and myeloproliferative neoplasms (MPN) has been sporadically reported in the literature, no systematic studies on this disease association are available. We retrospectively analyzed 46 patients affected by CLL/MPN referred by 15 Italian GIMEMA centers. The aim of this retrospective multicenter study was to define the following: clinico-biological characteristics, possible familiarity, clinical course of both diseases, and influence of MPN chemotherapy on the course of CLL. Among 46 patients, 30 patients were males, 16 patients were females; median age was 71 years. Only one case had familiar CLL. Myeloproliferative disorders consisted of essential thrombocytemia in 18 cases, polycythemia vera in 10 cases, chronic myeloid leukemia in 9 cases, primary myelofibrosis in 6 cases, and MPN/myelodysplastic syndrome in 3 cases. The lymphoproliferative disorder was diagnosed as monoclonal B-cell lymphocytosis in 8 patients and as Binet Stage A CLL in 38 patients. After a median follow-up of 49 months, 9 patients experienced progressive CLL and only 6 patients required treatment after a median of 57.5 months. The biological profile confirmed a subset of low-risk CLL. Twenty patients received chemotherapy for MPN without influence on the course of CLL: lymphocyte counts remained unchanged after 3, 6, and 12 months of treatment. This series is the largest so far reported in literature. The diagnosis of concomitant CLL/MPN is a rare event and lymphoproliferative disorders present a clinical indolent course with a low-risk biological profile. MPN therapy does not interfere with the prognosis of patients with CLL.
authors.affiliation: Hematology Institute, Catholic University, Largo A. Gemelli 8, Rome, Italy. l.laurenti@rm.unicatt.it
authors.forename: Luca
authors.initials: L
authors.lastname: Laurenti
authors.forename: Michela
authors.initials: M
authors.lastname: Tarnani
authors.forename: Ilaria
authors.initials: I
authors.lastname: Nichele
authors.forename: Stefania
authors.initials: S
authors.lastname: Ciolli
authors.forename: Agostino
authors.initials: A
authors.lastname: Cortelezzi
authors.forename: Francesco
authors.initials: F
authors.lastname: Forconi
authors.forename: Davide
authors.initials: D
authors.lastname: Rossi
authors.forename: Francesca Romana
authors.initials: FR
authors.lastname: Mauro
authors.forename: Giovanni
authors.initials: G
authors.lastname: D'Arena
authors.forename: Giovanni
authors.initials: G
authors.lastname: Del Poeta
authors.forename: Marco
authors.initials: M
authors.lastname: Montanaro
authors.forename: Fortunato
authors.initials: F
authors.lastname: Morabito
authors.forename: Caterina
authors.initials: C
authors.lastname: Musolino
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Callea
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Falchi
authors.forename: Alessandra
authors.initials: A
authors.lastname: Tedeschi
authors.forename: Achille
authors.initials: A
authors.lastname: Ambrosetti
authors.forename: Gianluca
authors.initials: G
authors.lastname: Gaidano
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Leone
authors.forename: Robin
authors.initials: R
authors.lastname: Foà
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D005260:Female; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000175:diagnosis / Q000503:physiopathology*; D008218:Lymphocytosis / Q000175:diagnosis / Q000503:physiopathology; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D009196:Myeloproliferative Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology*; D016609:Neoplasms, Second Primary / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology*; D016522:Oncology Service, Hospital; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors