title: Incidence and prognostic impact of other cancers in a population of long-term survivors of chronic lymphocytic leukemia.
abstract: Information on the impact of other cancers (OCs) in long-term survivors (LTSs) of chronic lymphocytic leukemia (CLL) is limited.
  
  
  
  Patients with CLL who survived >10 years were defined as LTSs of CLL. We calculated standardized incidence ratios (SIRs) to compare the incidence of OC in LTS of CLL versus the general population. A multivariable model was used to identify independent predictors of OC. Overall survival was analyzed as a function of the presence of OC.
  
  
  
  Among 797 LTSs of CLL, the cumulative frequency of OC was 36%, similar between 570 patients (72%) who required treatment for CLL (TRT) and 227 (28%) who remained untreated (UT). The most common OC in both groups was non-melanoma skin cancer, followed by prostate cancer, breast cancer, melanoma, lung cancer, and leukemia in TRT patients, and by prostate cancer, breast cancer, melanoma, lung cancer, and gastrointestinal tumors in the UT group. The SIR for all OC was 1.2 (P = 0.034). It was higher in males (SIR 1.31; P = 0.013) and patients <60 years (SIR 1.27; P = 0.027). A higher SIR was shown for secondary leukemia, melanoma, and head-and-neck cancers, whereas a lower SIR was found for gastrointestinal and bladder cancers. Independent predictors of OC development were advanced age, male gender, and lower platelets. The survival of patients with OC was 16.2 months and that of patients without OC 22.9 years.
  
  
  
  LTSs of CLL have an increased incidence of OC compared with the general population. CLL therapy is not a risk factor for OC in LTSs of CLL. The presence of an OC in these patients may be associated with shorter survival.
authors.affiliation: Department of Leukemia.
authors.forename: L
authors.initials: L
authors.lastname: Falchi
authors.affiliation: Department of Leukemia.
authors.forename: C
authors.initials: C
authors.lastname: Vitale
authors.affiliation: Department of Leukemia.
authors.forename: M J
authors.initials: MJ
authors.lastname: Keating
authors.affiliation: Department of Leukemia.
authors.forename: S
authors.initials: S
authors.lastname: Lerner
authors.affiliation: Department of Biostatistics.
authors.forename: X
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, USA.
authors.forename: K Y
authors.initials: KY
authors.lastname: Elhor Gbito
authors.affiliation: Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, USA.
authors.forename: S
authors.initials: S
authors.lastname: Strom
authors.affiliation: Department of Leukemia.
authors.forename: W G
authors.initials: WG
authors.lastname: Wierda
authors.affiliation: Department of Leukemia. Electronic address: aferrajo@mdanderson.org.
authors.forename: A
authors.initials: A
authors.lastname: Ferrajoli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology; D000073116:Cancer Survivors; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology; D008175:Lung Neoplasms / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology; D011379:Prognosis; D011471:Prostatic Neoplasms / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology; D012307:Risk Factors; D018426:SEER Program
keywords: chemotherapy; chronic lymphocytic leukemia; long-term survivor; other cancers; standardized incidence ratio; survival