Secondary primary malignancy presence and related factors in chronic lymphocytic leukemia

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Omer Ekinci
Ali Dogan
Sinan Demircioglu
Ergin Turgut
Cengiz Demir

Abstract

Objective: The secondary primary malignancy frequencies have seen increased in chronic lymphocytic leukemia (CLL) regardless of therapy. The aim of this study was to investigate the frequency of secondary primary malignancy in patients followed with the diagnosis of chronic lymphocytic leukemia.


Materials and Methods: The 183 patients with diagnosed of CLL were enrolled into this study. The data of the patients were evaluated retrospectively. Patients diagnosed with CLL were categorized according to age, gender and presence or absence of additional malignancy. Patients with CLL and concomitant malignancy were compared with other patients.


Results: Fifty four patients (29.5%) were female and 129 (70.5%) were male. Secondary primary malignancy was detected in 9 (%4,9) patients. CD5 positivity was found in all of the patients with malignancy and in 91% of whole patients. 5.4% of males and 3.7% of females had solid organ tumors with CLL. Although the proportion of solid tumors was higher in males, this difference was not statistically significant (p = 0.847). The mean age of cases with secondary malignancy was statistically significantly higher than that without secondary malignancy (p <0.05).


Conclusion:  In our study, all of the patients with the second primary malignancy were CD5 positive. BCL2 proto-oncogene levels were found increased in CD5-positive CLL cells, not in normal B cells those were positive for CD5. In vitro studies showed that, B-CLL cells with higher BCL2 levels survive is longer than cells with lower BCL2 levels. Presence of the secondary malignancy except CLL may be related with BCL2 increment as well as CD5 positivity. We need more comprehensive studies to determine the relationship between the presence of BCL2, CD5 positivity and  secondary malignancies.

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How to Cite
Ekinci, O. ., Dogan, A. ., Demircioglu, S. ., Turgut, E. ., & Demir, C. . (2018). Secondary primary malignancy presence and related factors in chronic lymphocytic leukemia. Medical Science and Discovery, 5(1), 106–109. Retrieved from https://medscidiscovery.com/index.php/msd/article/view/206
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Research Article

References

Smith A, Howell D, Patmore R, et al. Incidence of haematological malignancy by sub-type: a report from the Haematological Malignancy Research Network. Br J Cancer 2011; 105:1684.

Tsimberidou AM, Wen S, O'Brien S, et al. Assessment of chronic lymphocytic leukemia and small lymphocytic lymphoma by absolute lymphocyte counts in 2,126 patients: 20 years of experience at the University of Texas M.D. Anderson Cancer Center. J Clin Oncol 2007; 25:4648.

Thomas R, Ribeiro I, Shepherd P, et al. Spontaneous clinical regression in chronic lymphocytic leukaemia. Br J Haematol 2002; 116:341.

Rai KR, Sawitsky A, Cronkite EP, et al. Clinical staging of chronic lymphocytic leukemia. Blood 1975; 46:219.

Binet JL, Auquier A, Dighiero G, et al. A new prognostic classification of chronic lymphocytic leukemia derived from a multivariate survival analysis. Cancer 1981; 48:198.

Tsimberidou AM, Wen S, McLaughlin P, et al. Other malignancies in chronic lymphocytic leukemia/small lymphocytic lymphoma. J Clin Oncol 2009; 27:904.

Greene MH, Hoover RN, Fraumeni JF Jr. Subsequent cancer in patients with chronic lymphocytic leukemia--a possible immunologic mechanism. J Natl Cancer Inst 1978; 61:337.

Hisada M, Biggar RJ, Greene MH, et al. Solid tumors after chronic lymphocytic leukemia. Blood 2001; 98:1979.

Solomon BM, Rabe KG, Slager SL, et al. Overall and cancer-specific survival of patients with breast, colon, kidney, and lung cancers with and without chronic lymphocytic leukemia: a SEER population-based study. J Clin Oncol 2013; 31:930.

Bayram İ, Reçber D, İbiloğlu İ, Uğraş S.The Frequency And Distribution of Cancer Diagnosis In A Department of Pathology. Ege Tıp Dergisi 44 (1) : 21 - 27, 2005.

Demir V, Kahraman, Katg A, Pişkin Ö, Özsan GH, Demirkan F, Ündar B, Özcan MA. General Clinical Evaluation Of The Chronic Lymphocytic Leukemia Patients. DEÜ Tıp Fakültesi Dergisi 2012;26 (1): 9-19.

Dianzani U, Omedè P, Marmont F, et al. Expansion of T cells expressing low CD4 or CD8 levels in B-cell chronic lymphocytic leukemia: correlation with disease status and neoplastic phenotype. Blood 1994; 83:2198.

Scrivener S, Kaminski ER, Demaine A, Prentice AG. Analysis of the expression of critical activation/interaction markers on peripheral blood T cells in B-cell chronic lymphocytic leukaemia: evidence of immune dysregulation. Br J Haematol 2001; 112:959.

Christopoulos P, Pfeifer D, Bartholomé K, et al. Definition and characterization of the systemic T-cell dysregulation in untreated indolent B-cell lymphoma and very early CLL. Blood 2011; 117:3836.

Riches JC, Davies JK, McClanahan F, et al. T cells from CLL patients exhibit features of T-cell exhaustion but retain capacity for cytokine production. Blood 2013; 121:1612.

Görgün G, Holderried TA, Zahrieh D, et al. Chronic lymphocytic leukemia cells induce changes in gene expression of CD4 and CD8 T cells. J Clin Invest 2005; 115:1797.

Landau DA, Tausch E, Taylor-Weiner AN, et al. Mutations driving CLL and their evolution in progression and relapse. Nature 2015; 526:525.

Wang L, Lawrence MS, Wan Y, et al. SF3B1 and other novel cancer genes in chronic lymphocytic leukemia. N Engl J Med 2011; 365:2497.

Dighiero G. An attempt to explain disordered immunity and hypogammaglobulinemia in B-CLL. Nouv Rev Fr Hematol 1988; 30:283.

Diehl LF, Ketchum LH. Autoimmune disease and chronic lymphocytic leukemia: autoimmune hemolytic anemia, pure red cell aplasia, and autoimmune thrombocytopenia. Semin Oncol 1998; 25:80.

Sinisalo M, Aittoniemi J, Oivanen P, et al. Response to vaccination against different types of antigens in patients with chronic lymphocytic leukaemia. Br J Haematol 2001; 114:107.

Sampalo A, Navas G, Medina F, et al. Chronic lymphocytic leukemia B cells inhibit spontaneous Ig production by autologous bone marrow cells: role of CD95-CD95L interaction. Blood 2000; 96:3168.

Herishanu Y, Pérez-Galán P, Liu D, et al. The lymph node microenvironment promotes B-cell receptor signaling, NF-kappaB activation, and tumor proliferation in chronic lymphocytic leukemia. Blood 2011; 117:563.

Hockenbery D, Nuñez G, Milliman C, et al. Bcl-2 is an inner mitochondrial membrane protein that blocks programmed cell death. Nature 1990; 348:334.

Ricciardi MR, Petrucci MT, Gregorj C, et al. Reduced susceptibility to apoptosis correlates with kinetic quiescence in disease progression of chronic lymphocytic leukaemia. Br J Haematol 2001; 113:391.