title: Major infections, secondary cancers and autoimmune diseases occur in different clinical subsets of chronic lymphocytic leukaemia patients.
abstract: Major infections (MIs), secondary cancers (SCs) and autoimmune diseases (ADs) are the most common and relevant complications in patients with chronic lymphocytic leukaemia.
  
  
  
  We performed a single-centre retrospective study to investigate the prevalence of the above quoted complications, the association with most important prognostic markers and their impact on survival (n = 795).
  
  
  
  Almost one out of three patients experienced at least one complication and only 0.9% of the cohort developed all three complications. One hundred and twenty (20%) subjects developed SC, 98 MI (12%) and 80 AD (10%); these complications seem to occur in a mutually exclusive manner. By Kaplan-Meier analysis we estimated that after 20 years from the diagnosis SC, MI and AD occurred in 48%, 42% and 29% of patients, respectively. Furthermore, we showed that some clinical and biological markers are skewed among patients with different complications and that subjects with MI and SC had a worse prognosis than those with AD and all other patients (p < 0.0001).
  
  
  
  This study reveals the existence of different clinical subsets of chronic lymphocytic leukaemia patients characterised by an increased and different risk for developing specifically MI, SC and AD.
authors.affiliation: Hematology and Clinical Immunology Unit, Department of Medicine, University of Padua, Italy; Venetian Institute of Molecular Medicine, Centro di Eccellenza per la Ricerca Biomedica Avanzata, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Visentin
authors.affiliation: Hematology and Clinical Immunology Unit, Department of Medicine, University of Padua, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Imbergamo
authors.affiliation: Hematology and Clinical Immunology Unit, Department of Medicine, University of Padua, Italy.
authors.forename: Carmela
authors.initials: C
authors.lastname: Gurrieri
authors.affiliation: Hematology and Clinical Immunology Unit, Department of Medicine, University of Padua, Italy; Venetian Institute of Molecular Medicine, Centro di Eccellenza per la Ricerca Biomedica Avanzata, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Frezzato
authors.affiliation: Hematology and Clinical Immunology Unit, Department of Medicine, University of Padua, Italy; Venetian Institute of Molecular Medicine, Centro di Eccellenza per la Ricerca Biomedica Avanzata, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Trimarco
authors.affiliation: Hematology and Clinical Immunology Unit, Department of Medicine, University of Padua, Italy; Venetian Institute of Molecular Medicine, Centro di Eccellenza per la Ricerca Biomedica Avanzata, Italy.
authors.forename: Veronica
authors.initials: V
authors.lastname: Martini
authors.affiliation: Hematology and Clinical Immunology Unit, Department of Medicine, University of Padua, Italy; Venetian Institute of Molecular Medicine, Centro di Eccellenza per la Ricerca Biomedica Avanzata, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Severin
authors.affiliation: Hematology and Clinical Immunology Unit, Department of Medicine, University of Padua, Italy; Venetian Institute of Molecular Medicine, Centro di Eccellenza per la Ricerca Biomedica Avanzata, Italy.
authors.forename: Flavia
authors.initials: F
authors.lastname: Raggi
authors.affiliation: Hematology and Clinical Immunology Unit, Department of Medicine, University of Padua, Italy.
authors.forename: Edoardo
authors.initials: E
authors.lastname: Scomazzon
authors.affiliation: Hematology and Clinical Immunology Unit, Department of Medicine, University of Padua, Italy; Venetian Institute of Molecular Medicine, Centro di Eccellenza per la Ricerca Biomedica Avanzata, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Facco
authors.affiliation: Hematology and Clinical Immunology Unit, Department of Medicine, University of Padua, Italy; Venetian Institute of Molecular Medicine, Centro di Eccellenza per la Ricerca Biomedica Avanzata, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Piazza
authors.affiliation: Hematology and Clinical Immunology Unit, Department of Medicine, University of Padua, Italy; Venetian Institute of Molecular Medicine, Centro di Eccellenza per la Ricerca Biomedica Avanzata, Italy. Electronic address: g.semenzato@unipd.it.
authors.forename: Gianpietro
authors.initials: G
authors.lastname: Semenzato
authors.affiliation: Hematology and Clinical Immunology Unit, Department of Medicine, University of Padua, Italy; Venetian Institute of Molecular Medicine, Centro di Eccellenza per la Ricerca Biomedica Avanzata, Italy. Electronic address: livio.trentin@unipd.it.
authors.forename: Livio
authors.initials: L
authors.lastname: Trentin
mesh_terms: D000328:Adult; D000368:Aged; D001327:Autoimmune Diseases / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D007239:Infections / Q000453:epidemiology* / Q000209:etiology; D053208:Kaplan-Meier Estimate; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000150:complications*; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000453:epidemiology* / Q000209:etiology; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Autoimmune diseases; Chronic lymphocytic leukaemia; Hypogammaglobulinemia; Infections; Secondary cancers