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Blood, 15 September 2001, Vol. 98, No. 6, pp. 1979-1981
BRIEF REPORT
Solid tumors after chronic lymphocytic leukemia
Michie Hisada,
Robert J. Biggar,
Mark H. Greene,
Joseph F. Fraumeni Jr, and
Lois B. Travis
From the Division of Cancer Epidemiology and Genetics,
National Cancer Institute, Bethesda, MD.
Prior reports indicate that patients with chronic lymphocytic
leukemia (CLL) may be at increased risk of subsequent neoplasms. This
study quantified the risk of second cancers among 16 367 patients with
CLL in the population-based Surveillance, Epidemiology and End Results
Program. Overall, the observed/expected ratio (O/E) was 1.20 (95%
confidence interval [CI], 1.15-1.26). Second cancer risks for
patients who received chemotherapy only as the first course of
treatment (O/E = 1.21) were similar to risks for those who received no
treatment initially (O/E = 1.19). Significant excesses were found for
Kaposi sarcoma (O/E = 5.09), malignant melanoma (O/E = 3.18), and
cancers of the larynx (O/E = 1.72) and the lung (O/E = 1.66).
Increased risks were also found for brain cancer among men
(O/E =1.91) and for cancers of the stomach (O/E = 1.76) and
bladder (O/E = 1.52) among women. Additional investigations of
cancers after CLL are needed to explore the role of immunologic
impairment and/or other etiologic influences.
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