Incidence and impact of other malignancies after immunochemotherapy by fludarabine, cyclophosphamide, and rituximab as frontline treatment for chronic lymphocytic leukemia: A single-center retrospective study
Individuals with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) have a high risk of developing other malignancies (OMs). The development of OMs may be associated with the advanced age of CLL/SLL patients, presence of a tumor-promoting microenvironment, immune alterations inhe...
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| Veröffentlicht in: | Clinical hematology international 2025-01, Vol.7 (1), p.1-9 |
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| creator | Stocker, Nicolas Alsuliman, Tamim Corre, Elise Ricard, Laure Kaoui, Fazia Coppo, Paul Brissot, Eolia Dulery, Remy Banet, Anne Van de Wyngaert, Zoé Legrand, Ollivier Bonnin, Agnès Mohty, Mohamad Malard, Florent Marjanovic, Zora |
| description | Individuals with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) have a high risk of developing other malignancies (OMs). The development of OMs may be associated with the advanced age of CLL/SLL patients, presence of a tumor-promoting microenvironment, immune alterations inherent to CLL/SLL, or chemotherapy. Importantly, the occurrence of OMs following frontline fludarabine, cyclophosphamide and rituximab (FCR) treatment is associated with a reduction in the overall survival (OS). This retrospective study included 108 CLL/SLL patients treated with FCR immunochemotherapy, as a first line treatment. With a median follow-up of 94.9 (6-222) months, 31% developed an OM or more, within a median of 61.8 months post-FCR initiation. The most common OMs were non-melanoma skin cancers (7%), Richter’s syndrome (RS) (7%), myelodysplastic syndromes (6%), prostate cancer (4%), and acute myeloid leukemia (3%). Patients with OMs had shorter survival compared to those without (104.0 versus 149.0 months, P=0.02), with RS having the worst OS at 4.8 months (P |
| doi_str_mv | 10.46989/001c.127828 |
| format | Article |
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The development of OMs may be associated with the advanced age of CLL/SLL patients, presence of a tumor-promoting microenvironment, immune alterations inherent to CLL/SLL, or chemotherapy. Importantly, the occurrence of OMs following frontline fludarabine, cyclophosphamide and rituximab (FCR) treatment is associated with a reduction in the overall survival (OS). This retrospective study included 108 CLL/SLL patients treated with FCR immunochemotherapy, as a first line treatment. With a median follow-up of 94.9 (6-222) months, 31% developed an OM or more, within a median of 61.8 months post-FCR initiation. The most common OMs were non-melanoma skin cancers (7%), Richter’s syndrome (RS) (7%), myelodysplastic syndromes (6%), prostate cancer (4%), and acute myeloid leukemia (3%). Patients with OMs had shorter survival compared to those without (104.0 versus 149.0 months, P=0.02), with RS having the worst OS at 4.8 months (P<0.0001), followed by therapy-related myeloid neoplasia (t-MN) at 14.5 months. 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The development of OMs may be associated with the advanced age of CLL/SLL patients, presence of a tumor-promoting microenvironment, immune alterations inherent to CLL/SLL, or chemotherapy. Importantly, the occurrence of OMs following frontline fludarabine, cyclophosphamide and rituximab (FCR) treatment is associated with a reduction in the overall survival (OS). This retrospective study included 108 CLL/SLL patients treated with FCR immunochemotherapy, as a first line treatment. With a median follow-up of 94.9 (6-222) months, 31% developed an OM or more, within a median of 61.8 months post-FCR initiation. The most common OMs were non-melanoma skin cancers (7%), Richter’s syndrome (RS) (7%), myelodysplastic syndromes (6%), prostate cancer (4%), and acute myeloid leukemia (3%). Patients with OMs had shorter survival compared to those without (104.0 versus 149.0 months, P=0.02), with RS having the worst OS at 4.8 months (P<0.0001), followed by therapy-related myeloid neoplasia (t-MN) at 14.5 months. Although the onset of OMs in patients with CLL/SLL was observed after considerable delays, its impact on survival is significant in the immunochemotherapy era, necessitating a better understanding of these patterns to improve CLL/SLL management and guide future treatment strategies.</description><subject>Hematology</subject><subject>Human health and pathology</subject><subject>Life Sciences</subject><subject>Systematic Reviews</subject><issn>2590-0048</issn><issn>2590-0048</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2025</creationdate><recordtype>article</recordtype><recordid>eNpdks1u1DAQxyMEolXprQ_gK9KmtZ1snHBBqwpopZV6ac_R2J5sDLET2c6KvCWPhLOLUOHk0cxv_vPhybIbRm_LqqmbO0qZumVc1Lx-k13ybUNzSsv67Sv7IrsO4TullBesFE35PrsoGlGVnLLL7NejU0ajU0jAaWLsBCqSsSNj7NETC4M5OEgMBgJdTC5j7exG1aM9ITAtRC6kG2YNHqRxuCFqUcM49WOYerBJfXPS9ibOP40FSSCQzo8uDokm0SNEiy6SbvRE9SlgFBkWmwTUElcb5x9oDXwiOxKMOwyYq8SnXjxGn6qgiuaIJMRZLx-ydx0MAa__vFfZy9cvz_cP-f7p2-P9bp-rtK0q33IotWgUZaCwQ1FIITlvas2EFE2BFCulJVaC1xoQSrHVIEHIinU1aFEVV9nns-40S4t6bcjD0E4-TeiXdgTT_htxpm8P47FlTFC6ZavCx7NC_1_ew27frr70d3WqT48ssZszq9K8wWP3N4HR9nQJ7XoJ7fkSit_bTqyY</recordid><startdate>20250103</startdate><enddate>20250103</enddate><creator>Stocker, Nicolas</creator><creator>Alsuliman, Tamim</creator><creator>Corre, Elise</creator><creator>Ricard, Laure</creator><creator>Kaoui, Fazia</creator><creator>Coppo, Paul</creator><creator>Brissot, Eolia</creator><creator>Dulery, Remy</creator><creator>Banet, Anne</creator><creator>Van de Wyngaert, Zoé</creator><creator>Legrand, Ollivier</creator><creator>Bonnin, Agnès</creator><creator>Mohty, Mohamad</creator><creator>Malard, Florent</creator><creator>Marjanovic, Zora</creator><general>Atlantis Press International</general><general>SAABRON PRESS</general><scope>AAYXX</scope><scope>CITATION</scope><scope>1XC</scope><scope>VOOES</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-7316-5832</orcidid></search><sort><creationdate>20250103</creationdate><title>Incidence and impact of other malignancies after immunochemotherapy by fludarabine, cyclophosphamide, and rituximab as frontline treatment for chronic lymphocytic leukemia: A single-center retrospective study</title><author>Stocker, Nicolas ; Alsuliman, Tamim ; Corre, Elise ; Ricard, Laure ; Kaoui, Fazia ; Coppo, Paul ; Brissot, Eolia ; Dulery, Remy ; Banet, Anne ; Van de Wyngaert, Zoé ; Legrand, Ollivier ; Bonnin, Agnès ; Mohty, Mohamad ; Malard, Florent ; Marjanovic, Zora</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1276-52a4d79c01acefe73b7b2298d17b793e0e6cdbe6728daea475daba7b61f8ad763</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2025</creationdate><topic>Hematology</topic><topic>Human health and pathology</topic><topic>Life Sciences</topic><topic>Systematic Reviews</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Stocker, Nicolas</creatorcontrib><creatorcontrib>Alsuliman, Tamim</creatorcontrib><creatorcontrib>Corre, Elise</creatorcontrib><creatorcontrib>Ricard, Laure</creatorcontrib><creatorcontrib>Kaoui, Fazia</creatorcontrib><creatorcontrib>Coppo, Paul</creatorcontrib><creatorcontrib>Brissot, Eolia</creatorcontrib><creatorcontrib>Dulery, Remy</creatorcontrib><creatorcontrib>Banet, Anne</creatorcontrib><creatorcontrib>Van de Wyngaert, Zoé</creatorcontrib><creatorcontrib>Legrand, Ollivier</creatorcontrib><creatorcontrib>Bonnin, Agnès</creatorcontrib><creatorcontrib>Mohty, Mohamad</creatorcontrib><creatorcontrib>Malard, Florent</creatorcontrib><creatorcontrib>Marjanovic, Zora</creatorcontrib><collection>CrossRef</collection><collection>Hyper Article en Ligne (HAL)</collection><collection>Hyper Article en Ligne (HAL) (Open Access)</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Clinical hematology international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Stocker, Nicolas</au><au>Alsuliman, Tamim</au><au>Corre, Elise</au><au>Ricard, Laure</au><au>Kaoui, Fazia</au><au>Coppo, Paul</au><au>Brissot, Eolia</au><au>Dulery, Remy</au><au>Banet, Anne</au><au>Van de Wyngaert, Zoé</au><au>Legrand, Ollivier</au><au>Bonnin, Agnès</au><au>Mohty, Mohamad</au><au>Malard, Florent</au><au>Marjanovic, Zora</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Incidence and impact of other malignancies after immunochemotherapy by fludarabine, cyclophosphamide, and rituximab as frontline treatment for chronic lymphocytic leukemia: A single-center retrospective study</atitle><jtitle>Clinical hematology international</jtitle><date>2025-01-03</date><risdate>2025</risdate><volume>7</volume><issue>1</issue><spage>1</spage><epage>9</epage><pages>1-9</pages><issn>2590-0048</issn><eissn>2590-0048</eissn><abstract>Individuals with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) have a high risk of developing other malignancies (OMs). The development of OMs may be associated with the advanced age of CLL/SLL patients, presence of a tumor-promoting microenvironment, immune alterations inherent to CLL/SLL, or chemotherapy. Importantly, the occurrence of OMs following frontline fludarabine, cyclophosphamide and rituximab (FCR) treatment is associated with a reduction in the overall survival (OS). This retrospective study included 108 CLL/SLL patients treated with FCR immunochemotherapy, as a first line treatment. With a median follow-up of 94.9 (6-222) months, 31% developed an OM or more, within a median of 61.8 months post-FCR initiation. The most common OMs were non-melanoma skin cancers (7%), Richter’s syndrome (RS) (7%), myelodysplastic syndromes (6%), prostate cancer (4%), and acute myeloid leukemia (3%). Patients with OMs had shorter survival compared to those without (104.0 versus 149.0 months, P=0.02), with RS having the worst OS at 4.8 months (P<0.0001), followed by therapy-related myeloid neoplasia (t-MN) at 14.5 months. Although the onset of OMs in patients with CLL/SLL was observed after considerable delays, its impact on survival is significant in the immunochemotherapy era, necessitating a better understanding of these patterns to improve CLL/SLL management and guide future treatment strategies.</abstract><pub>Atlantis Press International</pub><pmid>39764201</pmid><doi>10.46989/001c.127828</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-7316-5832</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Hematology Human health and pathology Life Sciences Systematic Reviews |
| title | Incidence and impact of other malignancies after immunochemotherapy by fludarabine, cyclophosphamide, and rituximab as frontline treatment for chronic lymphocytic leukemia: A single-center retrospective study |
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