Volume 7, Issue S3 e24596f8
Oral Session
Open Access

S149: OTHER MALIGNANCIES IN THE HISTORY OF CLL: THE FINAL ANALYSIS OF THE INTERNATIONAL MULTICENTER STUDY CONDUCTED BY ERIC, IN HARMONY.

Thomas Chatzikonstantinou

Thomas Chatzikonstantinou

Institute of Applied Biosciences, Centre for Research and Technology Hellas

Search for more papers by this author
Lydia Scarfò

Lydia Scarfò

Università Vita-Salute San Raffaele and IRCC Ospedale San Raffaele

Search for more papers by this author
Georgios Karakatsoulis

Georgios Karakatsoulis

Institute of Applied Biosciences, Centre for Research and Technology Hellas

Department of Mathematics, University of Ioannina, Ioannina, Greece

Search for more papers by this author
Eva Minga

Eva Minga

Institute of Applied Biosciences, Centre for Research and Technology Hellas

Search for more papers by this author
Dimitra Chamou

Dimitra Chamou

Institute of Applied Biosciences, Centre for Research and Technology Hellas

Search for more papers by this author
Gloria Iacoboni

Gloria Iacoboni

Department of Haematology, University Hospital Vall d’Hebron, Autonomous University, Barcelona, Spain

Search for more papers by this author
Jana Kotaskova

Jana Kotaskova

Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech Republic

Department of Internal Medicine - Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic

Search for more papers by this author
Christos Demosthenous

Christos Demosthenous

Hematology Department and HCT Unit, G. Papanicolaou Hospital., Thessaloniki, Greece

Search for more papers by this author
Miguel Alcoceba

Miguel Alcoceba

Department of Haematology, University Hospital of Salamanca (HUS-IBSAL), CIBERONC (CB16/12/00233) and Cancer Research Centre (CIC-IBMCC, USAL-CSIC)., Salamanca, Spain

Search for more papers by this author
Salem Al-Shemari

Salem Al-Shemari

Department of Medicine, Faculty of Medicine, Kuwait University., Kuwait City, Kuwait

Search for more papers by this author
Thérèse Aurran-Schleinitz

Thérèse Aurran-Schleinitz

Department of Hemato-Oncology, Institut Paoli Calmette, Marseille, France

Search for more papers by this author
Francesca Bacchiarri

Francesca Bacchiarri

Division of Hematology, University of Siena, Siena, Italy

Search for more papers by this author
Mar Bellido

Mar Bellido

Hematology Department, University Medical Center Groningen, University of Groningen., Groningen, The Netherlands

Search for more papers by this author
Fontanet Bijou

Fontanet Bijou

Institut Bergonié, Bordeaux, France

Search for more papers by this author
Anne Calleja

Anne Calleja

Department of Hemato-Oncology, Institut Paoli Calmette, Marseille, France

Search for more papers by this author
Angeles Medina

Angeles Medina

Hospital Costa del Sol, Málaga, Spain

Search for more papers by this author
Mehreen Ali Khan

Mehreen Ali Khan

Department of Hematology and Stem Cell Transplant, Armed Forces Bone Marrow Transplant Center/National Institute of Blood and Marrow Transplant, Rawalpindi, Pakistan

Search for more papers by this author
Ramona Cassin

Ramona Cassin

Hematology Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico of Milan, Milan, Italy

Search for more papers by this author
Sofia Chatzileontiadou

Sofia Chatzileontiadou

Hematology Unit, 1st Dept of Internal Medicine, AUTH, AHEPA Hospital, Thessaloniki, Greece

Search for more papers by this author
Rosa Collado

Rosa Collado

Servicio de Hematología, Consorcio Hospital General Universitario de Valencia, Spain. Fundación de Investigación Hospital General Universitario de Valencia, Valencia, Spain

Search for more papers by this author
Zadie Davis

Zadie Davis

Department of Haematology, Royal Bournemouth Hospital, Bournemouth, United Kingdom

Search for more papers by this author
Maria Dimou

Maria Dimou

Department of Hematology and Bone Marrow transplantation Unit, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece

Search for more papers by this author
David Donaldson

David Donaldson

Clinical Haematology, Belfast City Hospital, Belfast, United Kingdom

Search for more papers by this author
Gimena Dos Santos

Gimena Dos Santos

Hospital de Clinicas, Montevideo, Uruguay

Search for more papers by this author
Barbara Dreta

Barbara Dreta

Division of hematology, Department of Internal Medicine, University Hospital Center Zagreb, Zagreb, Croatia

Search for more papers by this author
Maria Efstathopoulou

Maria Efstathopoulou

Department of Haematology Athens Medical Center-Psychikon Branch, Athens, Greece

Search for more papers by this author
Shaimaa El-Ashwah

Shaimaa El-Ashwah

Oncology Center, Mansoura University, Mansoura, Egypt

Search for more papers by this author
Alicia Enrico

Alicia Enrico

Hospital Italiano La Plata, Buenos Aires, Argentina

Search for more papers by this author
Alberto Fresa

Alberto Fresa

Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy

Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy

Search for more papers by this author
Sara Galimberti

Sara Galimberti

Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Pisa, Italy

Search for more papers by this author
Andrea Galitzia

Andrea Galitzia

Hematology and Stem Cell Transplantation Unit, Ospedale Oncologico A. Businco, ARNAS “G. Brotzu”, Cagliari, Italy

Search for more papers by this author
Rocío García-Serra

Rocío García-Serra

Servicio de Hematología, Consorcio Hospital General Universitario de Valencia, Spain. Fundación de Investigación Hospital General Universitario de Valencia, Valencia, Spain

Search for more papers by this author
Eva Gimeno

Eva Gimeno

Department of Hematology, Hospital del Mar, Barcelona, Spain

Search for more papers by this author
Isabel González-Gascón-Y-Marín

Isabel González-Gascón-Y-Marín

Hematology Department Infanta Leonor University Hospital, Madrid, Spain

Search for more papers by this author
Alessandro Gozzetti

Alessandro Gozzetti

Division of Hematology, University of Siena, Siena, Italy

Search for more papers by this author
Valerio Guarente

Valerio Guarente

Institute of Hematology and Center for Hemato-Oncology Research, University of Perugia and Santa Maria della Misericordia Hospital, Perugia, Italy

Search for more papers by this author
Romain Guieze

Romain Guieze

Department of Hematology and Cell Therapy, Estaing University Hospital, Clermont-Ferrand, France

Search for more papers by this author
Ajay Gogia

Ajay Gogia

Laboratory Oncology Unit, Dr. B.R.A. IRCH, All India Institute of Medical Sciences (AIIMS), New Delhi, India

Search for more papers by this author
Ritu Gupta

Ritu Gupta

Laboratory Oncology Unit, Dr. B.R.A. IRCH, All India Institute of Medical Sciences (AIIMS), New Delhi, India

Search for more papers by this author
Sean Harrop

Sean Harrop

Peter MacCallum Cancer Centre, St Vincent’s Hospital, University of Melbourne, Melbourne, Victoria, 3000 Australia

University of Melbourne, Victoria, Australia

Search for more papers by this author
Eleftheria Hatzimichael

Eleftheria Hatzimichael

Department of Haematology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Stavros Niarchos Avenue, Ioannina, Greece

Search for more papers by this author
Yair Herishanu

Yair Herishanu

Department of Hematology, Tel Aviv Sourasky Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel

Search for more papers by this author
José-Ángel Hernández-Rivas

José-Ángel Hernández-Rivas

Hematology Department Infanta Leonor University Hospital, Madrid, Spain

Search for more papers by this author
Luca Inchiappa

Luca Inchiappa

Department of Hemato-Oncology, Institut Paoli Calmette, Marseille, France

Search for more papers by this author
Ozren Jaksic

Ozren Jaksic

Department of Hematology, University hospital Dubrava, Zagreb, Croatia

Search for more papers by this author
Susanne Janssen

Susanne Janssen

Dept of Hematology, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands

Search for more papers by this author
Elżbieta Kalicińska

Elżbieta Kalicińska

Department and Clinic of Hematology, Blood Neoplasms and Bone Marrow Transplantation Wroclaw Medical University, Wroclaw, Poland

Search for more papers by this author
Laribi Kamel

Laribi Kamel

Department of Hematology, Centre Hospitalier Le Mans, Le Mans, France

Search for more papers by this author
Volkan Karakus

Volkan Karakus

Antalya Training and Research Hospital, Antalya, Turkey

Search for more papers by this author
Arnon P Kater

Arnon P Kater

Dept of Hematology, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands

Search for more papers by this author
Bonnie Kho

Bonnie Kho

Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong

Search for more papers by this author
Maria Kislova

Maria Kislova

Department of Hematology, Oncology, and Chemotherapy, S. P. Botkin’s City Hospital, Moscow, Russia

Search for more papers by this author
Εliana Konstantinou

Εliana Konstantinou

Haematology, University of Athens, Laikon General Hospital, Athens, Greece

Search for more papers by this author
Maya Koren-Michowitz

Maya Koren-Michowitz

Department of Hematology, Shamir Medical Center, Zerifin, Israel

Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel

Search for more papers by this author
Ioannis Kotsianidis

Ioannis Kotsianidis

Department of Hematology, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece

Search for more papers by this author
Robert J Kreitman

Robert J Kreitman

Laboratory of Molecular Biology, National Cancer Institute, National Institutes of Health, Bethesda, United States

Search for more papers by this author
Jorge Labrador

Jorge Labrador

Department of Hematology, Hospital Universitario de Burgos, Burgos, Spain

Search for more papers by this author
Deepesh Lad

Deepesh Lad

Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Search for more papers by this author
Mark-David Levin

Mark-David Levin

Department of Internal Medicine, Albert Schweitzer Hospital, Dordrecht, The Netherlands

Search for more papers by this author
Ilana Levy

Ilana Levy

Hematology, Bnai-Zion Medical Center, Haifa, Israel

Search for more papers by this author
Thomas Longval

Thomas Longval

Service d’Hématologie Oncologie, Centre Hospitalier de Versailles, Le Chesnay, France

Search for more papers by this author
Alberto Lopez-Garcia

Alberto Lopez-Garcia

Fundacion Jimenez Diaz University Hospital, Health Research Institute IIS-FJD, Madrid, Spain

Search for more papers by this author
Juan Marquet

Juan Marquet

Hematology Department, Ramón y Cajal University Hospital, Madrid, Spain

Search for more papers by this author
Marc Maynadié

Marc Maynadié

Biological Haematology Department, Dijon Bourgogne University Hospital, Haematological Malignancies Registry, Dijon, France

Search for more papers by this author
Stanislava Maslejova

Stanislava Maslejova

Department of Internal Medicine - Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic

Search for more papers by this author
Carlota Mayor-Bastida

Carlota Mayor-Bastida

Haematology Department, Hospital Universitario de La Princesa, Madrid, Spain

Search for more papers by this author
Biljana Mihaljevic

Biljana Mihaljevic

Clinic for hematology, University Clinical Center of Serbia, Belgrade, Serbia

Search for more papers by this author
Ivana Milosevic

Ivana Milosevic

University of Novi Sad, Faculty of Medicine, Clinical Centre of Vojvodina, Novi Sad, Serbia

Search for more papers by this author
Fatima Miras

Fatima Miras

Hematology Department Hospital Universitario 12 de Octubre, Madrid, Spain

Search for more papers by this author
Riccardo Moia

Riccardo Moia

Division of Hematology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy

Search for more papers by this author
Marta Morawska

Marta Morawska

Experimental Hematooncology Department, Medical University of Lublin, Lublin, Poland

Hematology Department, St. John’s Cancer Center, Lublin, Poland

Search for more papers by this author
Roberta Murru

Roberta Murru

Hematology and Stem Cell Transplantation Unit, Ospedale Oncologico A. Businco, ARNAS “G. Brotzu”, Cagliari, Italy

Search for more papers by this author
Uttam Kumar Nath

Uttam Kumar Nath

Department of Medical Oncology & Hematology, All India Institute of Medical Sciences, Rishikesh, India

Search for more papers by this author
Almudena Navarro-Bailón

Almudena Navarro-Bailón

Department of Haematology, University Hospital of Salamanca (HUS-IBSAL), CIBERONC (CB16/12/00233) and Cancer Research Centre (CIC-IBMCC, USAL-CSIC)., Salamanca, Spain

Search for more papers by this author
Ana C. Oliveira

Ana C. Oliveira

Department of Clinical Hematology, ICO, Hospital Duran i Reynals, IDIBELL, Barcelona, Spain

Search for more papers by this author
Jacopo Olivieri

Jacopo Olivieri

Hematology Clinic, ASUFC, Udine, Italy

Search for more papers by this author
David Oscier

David Oscier

Department of Haematology, Royal Bournemouth Hospital, Bournemouth, United Kingdom

Search for more papers by this author
Irina Panovska-Stavridis

Irina Panovska-Stavridis

University Clinic of Hematology, Medical Faculty, University Ss. Cyril and Methodius, Skopje, Macedonia

Search for more papers by this author
Maria Papaioannou

Maria Papaioannou

Hematology Unit, 1st Dept of Internal Medicine, AUTH, AHEPA Hospital, Thessaloniki, Greece

Search for more papers by this author
Tomas Papajík

Tomas Papajík

Department of Hemato-Oncology, Faculty of Medicine and Dentistry, Palacký University and University Hospital Olomouc, Olomouc, Czech Republic

Search for more papers by this author
Punyarat Phumphukhieo

Punyarat Phumphukhieo

Hull York Medical School, Hull, United Kingdom

Search for more papers by this author
Cheyenne Pierie

Cheyenne Pierie

Dept of Hematology, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands

Search for more papers by this author
Anna Puiggros

Anna Puiggros

Molecular Cytogenetics Laboratory, Pathology Department, Hospital del Mar and Translational Research on Hematological Neoplasms Group, Hospital del Mar Research Institute (IMIM), Barcelona, Spain

Search for more papers by this author
Lata Rani

Lata Rani

Laboratory Oncology Unit, Dr. B.R.A. IRCH, All India Institute of Medical Sciences (AIIMS), New Delhi, India

Search for more papers by this author
Gianluigi Reda

Gianluigi Reda

Hematology Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico of Milan, Milan, Italy

Search for more papers by this author
Gian Matteo Rigolin

Gian Matteo Rigolin

St. Anna University Hospital, Ferrara, Italy

Search for more papers by this author
Aharon Ronson

Aharon Ronson

Department of Hematology, Shaare-Zedek Medical Center, affiliated with the Hebrew University Medical School, Jerusalem, Israel

Search for more papers by this author
Rosa Ruchlemer

Rosa Ruchlemer

Department of Hematology, Shaare-Zedek Medical Center, affiliated with the Hebrew University Medical School, Jerusalem, Israel

Search for more papers by this author
Marcos Daniel de Deus Santos

Marcos Daniel de Deus Santos

Universidade Federal do Espírito Santo, Internal Medicine Department, Vila Velha, ES, Brazil

Search for more papers by this author
Mattia Schipani

Mattia Schipani

Division of Hematology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy

Search for more papers by this author
Annett Schiwitza

Annett Schiwitza

Hematology and Oncology, Faculty of Medicine, University of Augsburg, Augsburg, Germany

Search for more papers by this author
Yandong Shen

Yandong Shen

Royal North Shore Hospital, Sydney, Australia

Search for more papers by this author
Martin Simkovic

Martin Simkovic

4th Department of Internal Medicine -Haematology, University Hospital and Faculty of Medicine, Hradec Králové, Czech Republic

Search for more papers by this author
Svetlana Smirnova

Svetlana Smirnova

Consultative Hematology Department with a Day Hospital for Intensive High-Dose Chemotherapy, National Medical Research Center for Hematology, Moscow, Russia

Search for more papers by this author
Dina Sameh Abdelrahman Soliman

Dina Sameh Abdelrahman Soliman

Hematopathology Laboratory, Hamad Medical Corporation, Doha, Qatar

Search for more papers by this author
Martin Spacek

Martin Spacek

1st Department of Medicine - Hematology, First Faculty of Medicine, Charles University and General Hospital in Prague, Prague, Czech Republic

Search for more papers by this author
Tamar Tadmor

Tamar Tadmor

Hematology, Bnai-Zion Medical Center, Haifa, Israel

Search for more papers by this author
Kristina Tomic

Kristina Tomic

Clinic for hematology, University Clinical Center of Serbia, Belgrade, Serbia

Search for more papers by this author
Eric Tse

Eric Tse

Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Hong Kong, Hong Kong

Search for more papers by this author
Theodoros Vassilakopoulos

Theodoros Vassilakopoulos

Haematology, University of Athens, Laikon General Hospital, Athens, Greece

Search for more papers by this author
Andrea Visentin

Andrea Visentin

Hematology and Clinical Immunology Unit, Department of Medicine, University of Padova, Padova, Italy

Search for more papers by this author
Candida Vitale

Candida Vitale

Division of Hematology, A.O.U. Città della Salute e della Scienza di Torino and Department of Molecular Biotechnology and Health Sciences, University of Turin, Turin, Italy

Search for more papers by this author
Julia von Tresckow

Julia von Tresckow

Clinic for Hematology and Stem Cell Transplantation, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany

Search for more papers by this author
George Vrachiolias

George Vrachiolias

Department of Hematology, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece

Search for more papers by this author
Vojin Vukovic

Vojin Vukovic

Clinic for hematology, University Clinical Center of Serbia, Belgrade, Serbia

University of Belgrade Faculty of Medicine, Belgrade, Serbia

Search for more papers by this author
Renata Walewska

Renata Walewska

Department of Haematology, Royal Bournemouth Hospital, Bournemouth, United Kingdom

Search for more papers by this author
Ewa Wasik-Szczepanek

Ewa Wasik-Szczepanek

Dept. Hematooncology and Bone Marrow Transplantation Medical University in Lublin, Lublin, Poland

Search for more papers by this author
Zhenshu Xu

Zhenshu Xu

Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fujian Medical University Union Hospital, Fuzhou, China

Search for more papers by this author
Munci Yagci

Munci Yagci

Gazi University Medical Faculty, Ankara, Turkey

Search for more papers by this author
Lucrecia Yañez

Lucrecia Yañez

Hematology Department, University Hospital Marqués de Valdecilla (IDIVAL), University of Cantabria, Santander, Spain

Search for more papers by this author
Mohamed Yassin

Mohamed Yassin

Hematology section, Department of Medical Oncology, National Center for Cancer Care and Research, Doha, Qatar

Search for more papers by this author
Jana Zuchnicka

Jana Zuchnicka

Department of Haematooncology, University Hospital Ostrava, Ostrava, Czech Republic

Search for more papers by this author
Maria Angelopoulou

Maria Angelopoulou

Haematology, University of Athens, Laikon General Hospital, Athens, Greece

Search for more papers by this author
Darko Antic

Darko Antic

Clinic for hematology, University Clinical Center of Serbia, Belgrade, Serbia

University of Belgrade Faculty of Medicine, Belgrade, Serbia

Search for more papers by this author
Bella Biderman

Bella Biderman

Department of Molecular Hematology, National Medical Research Center for Hematology, Moscow, Russia

Search for more papers by this author
Mark Catherwood

Mark Catherwood

Clinical Haematology, Belfast City Hospital, Belfast, United Kingdom

Search for more papers by this author
Rainer Claus

Rainer Claus

Pathology, Faculty of Medicine, University of Augsburg, Stenglinstrasse 2, Augsburg, Germany

Comprehensive Cancer Center Augsburg, Faculty of Medicine, University of Augsburg, Stenglinstrasse 2, Augsburg, Germany

Search for more papers by this author
Marta Coscia

Marta Coscia

Division of Hematology, A.O.U. Città della Salute e della Scienza di Torino and Department of Molecular Biotechnology and Health Sciences, University of Turin, Turin, Italy

Search for more papers by this author
Antonio Cuneo

Antonio Cuneo

St. Anna University Hospital, Ferrara, Italy

Search for more papers by this author
Fatih Demirkan

Fatih Demirkan

Dokuz Eylul University, Division of Hematology, Izmir, Turkey

Search for more papers by this author
Blanca Espinet

Blanca Espinet

Molecular Cytogenetics Laboratory, Pathology Department, Hospital del Mar and Translational Research on Hematological Neoplasms Group, Hospital del Mar Research Institute (IMIM), Barcelona, Spain

Search for more papers by this author
Gianluca Gaidano

Gianluca Gaidano

Division of Hematology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy

Search for more papers by this author
Olga Kalashnikova

Olga Kalashnikova

Federal State Budgetary Educational Institution of Higher Education Academician I.P. Pavlov First St. Petersburg State Medical University of the Ministry of Healthcare of Russian Federation, St. Petersburg, Russia

Search for more papers by this author
Luca Laurenti

Luca Laurenti

Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy

Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy

Search for more papers by this author
Eugene Nikitin

Eugene Nikitin

Department of Hematology, Oncology, and Chemotherapy, S. P. Botkin’s City Hospital, Moscow, Russia

Search for more papers by this author
Gerassimos A. Pangalis

Gerassimos A. Pangalis

Department of Haematology Athens Medical Center-Psychikon Branch, Athens, Greece

Search for more papers by this author
Panagiotis Panagiotidis

Panagiotis Panagiotidis

Department of Hematology and Bone Marrow transplantation Unit, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece

Search for more papers by this author
Stephen Mulligan

Stephen Mulligan

Royal North Shore Hospital, Sydney, Australia

Search for more papers by this author
Viola Maria Popov

Viola Maria Popov

Hematology Department Colentina Clinical Hospital, Bucharest, Romania

Search for more papers by this author
Sarka Pospisilova

Sarka Pospisilova

Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech Republic

Search for more papers by this author
Lukas Smolej

Lukas Smolej

4th Department of Internal Medicine -Haematology, University Hospital and Faculty of Medicine, Hradec Králové, Czech Republic

Search for more papers by this author
Paolo Sportoletti

Paolo Sportoletti

Institute of Hematology and Center for Hemato-Oncology Research, University of Perugia and Santa Maria della Misericordia Hospital, Perugia, Italy

Search for more papers by this author
Niki Stavroyianni

Niki Stavroyianni

Hematology Department and HCT Unit, G. Papanicolaou Hospital., Thessaloniki, Greece

Search for more papers by this author
Constantine Tam

Constantine Tam

Peter MacCallum Cancer Centre, St Vincent’s Hospital, University of Melbourne, Melbourne, Victoria, 3000 Australia

University of Melbourne, Victoria, Australia

Search for more papers by this author
Livio Trentin

Livio Trentin

Hematology and Clinical Immunology Unit, Department of Medicine, University of Padova, Padova, Italy

Search for more papers by this author
Anastasia Chatzidimitriou

Anastasia Chatzidimitriou

Institute of Applied Biosciences, Centre for Research and Technology Hellas

Search for more papers by this author
Francesc Bosch

Francesc Bosch

Department of Haematology, University Hospital Vall d’Hebron, Autonomous University, Barcelona, Spain

Search for more papers by this author
Michael Doubek

Michael Doubek

Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech Republic

Department of Internal Medicine - Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic

Search for more papers by this author
Paolo Ghia

Paolo Ghia

Università Vita-Salute San Raffaele and IRCC Ospedale San Raffaele

Search for more papers by this author
Kostas Stamatopoulos

Kostas Stamatopoulos

Institute of Applied Biosciences, Centre for Research and Technology Hellas

Search for more papers by this author

Background: Patients with chronic lymphocytic leukemia (CLL) have a higher risk of developing other malignancies (OMs) compared to the general population. However, the impact of CLL-related risk factors and CLL-directed treatment is still unclear.

Aims: We aimed to (i) determine the incidence of OMs in a population of patients with CLL, (ii) assess the overall survival (OS) of patients with CLL and OM, and (iii) find risk factors for the occurrence of OM in patients with CLL.

Methods: This is a retrospective international multicenter study conducted by the European Research Initiative on CLL, in the context of HARMONY. Investigators at each participating site provided data on consecutive sets of patients diagnosed with CLL/small lymphocytic lymphoma (SLL) or high-count CLL-like monoclonal B-cell lymphocytosis (MBL) between 2000-2016. The study was approved by the local institutional ethics committees.

Results: Data on 19,705 patients from 85 different centers in 33 countries was collected. The median age at CLL diagnosis was 65 years [interquartile range (IQR) 57-73], and the median follow-up from CLL diagnosis was 6.2 years (IQR 3.72-9.6). The majority of patients had CLL (18,386, 93.3%), while 528 (2.7%) and 791 (4%) were diagnosed with SLL and MBL, respectively. At last follow-up, 10,146 (53%) patients had received at least one line of treatment (median 1, IQR 1-2).

Diagnosis of OM was reported in 4,134/19,705 (21%) patients with CLL [633 (3.2%) had Richter transformation (RT) or B cell prolymphocytic leukemia]. In 2,910/4,134 (70.4%) patients, the OM postdated the diagnosis of CLL; in 854/4,134 (20.6%), the OM either antedated or was diagnosed concurrently with CLL; finally, in 322/4,134 (7.8%), an OM was diagnosed both before and after CLL diagnosis. Overall, 3,513 OMs were diagnosed in 130,166.9 years of follow-up after CLL diagnosis (26.9 OMs/1,000 person-years).

The most common hematological OMs were myelodysplastic syndrome (MDS) (87/19,705, 0.44%), followed by acute myeloid leukemia (AML) (42/19,705, 0.21%) and multiple myeloma (37/19,705, 0.19%). Treatment with fludarabine and cyclophosphamide with/without rituximab (FC+/-R) was the only statistically significant risk factor for MDS/AML in the multivariate analysis, while only 13q deletions were associated with hematological OMs (excluding MDS/AML and RT).

Non-melanoma skin cancers (NMSC) (986/19,705, 5%) and prostate cancers (PCs) (530/19,705, 2.7%) were the most frequent solid tumors (ST), followed by colon (382/19,705, 1.9%) and breast cancers (343/19,705, 1.7%). Male patients and those with unmutated immunoglobulin heavy variable (IGHV) gene status had a higher risk of developing an ST (excluding NMSC).

The most frequent STs (>100 cases) were analyzed separately and statistically significant (p<0.05) associations were found between (i) NMSC development and male gender, older age at diagnosis, and FC+/-R treatment; (ii) male gender and colorectal and bladder cancers; (iii) unmutated IGHV gene status and melanoma, lung and breast cancers.

The effect of CLL-directed treatment varied between different STs. Treated patients were more likely to develop NMSC and PC (OR=1.8;95%CI=1.36-2.41; p<0.001/OR=2.11;95%CI=1.12-3.97; p=0.021), while breast cancers were more frequent in untreated patients (OR=0.17;95%CI=0.08-0.33; p<0.001).

Patients with CLL and an OM had inferior OS than those without. MDS/AML conferred the worst OS (Figure).

Summary/Conclusion: OMs in CLL impact on OS. FC+/-R is associated with increased risk of MDS/AML. Accurate assessment of the risk of OMs in patients treated with chemo-free regimens requires further investigation.

Keywords: B cell chronic lymphocytic leukemia

    The full text of this article hosted at iucr.org is unavailable due to technical difficulties.