EHA Library - The official digital education library of European Hematology Association (EHA)

Our study aims to present the incidence in our population and predicting whether stage and previous chemotherapies could have a negative impact on the number of second cancer in patients of CLL at our Hospital.

We retrospective evaluated 178 patients of CLL registered at General Hospital of Limassol, in Cyprus over a period of 19 years (1995 - 2014). A second malignancy was defined as another malignancy at the time of diagnosis or during follow up.

There were 178 patients, 75 females and 103 males. The average age, was 67 years (34-94 years). The common presenting features were lymphocytosis 86%, lymphadenopathy 82%, splenomegaly 20%, and hepatomegaly 7%. Analysing data for all the patients, at diagnosis, 79% were early stage, (Rai stage 0- 46,3%, Rai stage I- 14,7%, Rai stage II-18%) and 21% of cases were in advanced stage, (Rai stage III- 18,6%, Rai stage IV- 2,4%). Twenty seven percent of patients received treatment at presentation or at disease progression, including chlorambucil, fludarabine, rituximab and bendamustine based regimens. During the follow up, we noticed 27 cancers, including two haematological malignancies along with cancer of breast, uterus, lung, prostate, colon, skin, pancreas renal and larynx. We also found two high grade transformation (Richter syndrome), two cases of prostate infiltration and one case of breast infiltration by chronic lymphocytic leukaemia (Table I). Median time between CLL and second cancer diagnosis was 5.01 years (0-16 years). According to correlation analysis, neither advanced stage nor previous chemotherapies influenced with statistical significance the incidence of second malignancy in patients with CLL in our Hospital. Moreover the second tumour did not predisposed shortness of patient’s survival and chemotherapy has no impact in the time of cancer diagnosis.

The incidence of second cancer is 15,3% in our population. Advanced stage and previous chemotherapies have none impact in this incidence and did not influenced the survival of the patient, comparing with the survival of the non-cancer patients. Unfortunately, the majority of our patients has diagnosed before the facility for molecular and cytogenetic analysis became feasible in Cyprus, that didn’t let us to include modern prognostic factors in our study.