Universität zu Köln

Maurer, C., Langerbeins, P., Bahlo, J., Cramer, P., Fink, A. M., Pflug, N., Engelke, A., von Tresckow, J., Kovacs, G., Stilgenbauer, S., Wendtner, C-M, Mueller, L., Ritgen, M., Seiler, T., Fischer, K., Hallek, M. and Eichhorst, B. (2016). Effect of first-line treatment on second primary malignancies and Richter's transformation in patients with CLL. Leukemia, 30 (10). S. 2019 - 2026. LONDON: NATURE PUBLISHING GROUP. ISSN 1476-5551

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Abstract

This study aimed to assess the frequency of and the contributing factors for second primary malignancies (SPMs) and Richter's transformations (RTs) following first-line treatment of chronic lymphocytic leukemia within four phase II/III trials of the GCLLSG evaluating fludarabine (F) vs F+cyclophosphamide (FC), chlorambucil vs F, FC without or with rituximab, and bendamustine+R (BR). Among 1458 patients, 239 (16.4%) experienced either an SPM (N = 191) or a RT (N = 75). Solid tumors (N = 115; 43.2% of all second neoplasias) appeared most frequently, followed by RTs (N = 75; 28.2%). Patients showed a 1.23-fold increased risk of solid tumors in comparison to the age-matched general population from the German cancer registry. Age>65 (hazard ratio (HR) 2.1; P<0.001), male sex (HR 1.7; P = 0.01), co-morbidities (HR 1.6; P = 0.01) and number of subsequent treatments >= 1 (HR 12.1; P<0.001) showed an independent adverse prognostic impact on SPM-free survival. Serum thymidine kinase > 10 U/l at trial enrollment (HR 3.9; P = 0.02), non-response to first-line treatment (HR 3.6; P<0.001) and number of subsequent treatments >= 1 (HR 30.2; P<0.001) were independently associated with increased risk for RT.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Maurer, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Langerbeins, P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bahlo, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Cramer, P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Fink, A. M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Pflug, N. UNSPECIFIED UNSPECIFIED UNSPECIFIED Engelke, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED von Tresckow, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kovacs, G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Stilgenbauer, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wendtner, C-M UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller, L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Ritgen, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Seiler, T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Fischer, K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hallek, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Eichhorst, B. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-260608
DOI:	10.1038/leu.2016.113
Journal or Publication Title:	Leukemia
Volume:	30
Number:	10
Page Range:	S. 2019 - 2026
Date:	2016
Publisher:	NATURE PUBLISHING GROUP
Place of Publication:	LONDON
ISSN:	1476-5551
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CHRONIC LYMPHOCYTIC-LEUKEMIA; CELL LYMPHOMA; CLINICAL CHARACTERISTICS; SINGLE-INSTITUTION; THERAPY; CANCER; FLUDARABINE; IMMUNOSUPPRESSION; CHLORAMBUCIL; RITUXIMAB Multiple languages Oncology; Hematology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/26060