title: Chronic lymphocytic leukemia is associated with decreased survival of patients with malignant melanoma and Merkel cell carcinoma in a SEER population-based study.
abstract: OBJECTIVE
  To delineate outcomes of malignant melanoma (MM) and Merkel cell carcinoma (MCC) in patients with chronic lymphocytic leukemia (CLL) or non-Hodgkin's lymphoma (NHL).
  
  
  METHODS
  We identified patients with MM or MCC reported to the Surveillance, Epidemiology, and End Results program and analyzed the effects of history of CLL/NHL on overall (OS) and cause-specific survival after MM or MCC. Expected survival was derived from patients with MM or MCC without CLL/NHL.
  
  
  RESULTS
  From 1990 to 2006, 212,245 patients with MM and 3,613 patients with MCC were identified, of whom 1,246 with MM and 90 with MCC had a prior diagnosis of CLL/NHL. Patients with MM and a history of CLL/NHL had worse-than-expected OS as measured by standardized mortality ratio (SMR; SMR for CLL, 2.6; 95% CI, 2.3 to 3.0; SMR for NHL, 2.3; 95% CI, 2.1 to 2.6). MM cause-specific survival was worse than expected for patients with a history of CLL (SMR, 2.8; 95% CI, 2.2 to 3.4) or NHL (SMR, 2.1; 95% CI, 1.7 to 2.6). Among patients with MCC, OS was worse than expected for those with a history of CLL (SMR, 3.1; 95% CI, 2.2 to 4.3) or NHL (SMR, 1.9; 95% CI, 1.3 to 2.8). MCC cause-specific survival was worse than expected for patients with a history of CLL (SMR, 3.8; 95% CI, 2.5 to 5.9), but no difference was observed for NHL (SMR, 0.9; 95% CI, 0.4 to 2.1).
  
  
  CONCLUSIONS
  Patients with CLL before diagnosis of MM or MCC have significantly worse OS and MM or MCC cause-specific survival than those without a history of CLL/NHL.
authors.affiliation: Mayo Clinic, Rochester, MN 55905, USA. brewer.jerry@mayo.edu
authors.forename: Jerry D
authors.initials: JD
authors.lastname: Brewer
authors.forename: Tait D
authors.initials: TD
authors.lastname: Shanafelt
authors.forename: Clark C
authors.initials: CC
authors.lastname: Otley
authors.forename: Randall K
authors.initials: RK
authors.lastname: Roenigk
authors.forename: James R
authors.initials: JR
authors.lastname: Cerhan
authors.forename: Neil E
authors.initials: NE
authors.lastname: Kay
authors.forename: Amy L
authors.initials: AL
authors.lastname: Weaver
authors.forename: Timothy G
authors.initials: TG
authors.lastname: Call
mesh_terms: D000368:Aged; D015266:Carcinoma, Merkel Cell / Q000150:complications / Q000401:mortality*; D005260:Female; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000150:complications*; D008228:Lymphoma, Non-Hodgkin / Q000150:complications; D008297:Male; D008545:Melanoma / Q000150:complications / Q000401:mortality*; D008875:Middle Aged; D018426:SEER Program; D012878:Skin Neoplasms / Q000150:complications / Q000401:mortality*; D014481:United States