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Santoro A, Rilke F, Franchi F, Monfardini S. Primary Malignant Neoplasms Associated with Chronic Lymphocytic Leukemia. TUMORI JOURNAL 2018; 66:431-7. [PMID: 7414709 DOI: 10.1177/030089168006600404] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Over the past 2 decades there has been an almost exponential increase in the frequency with which cases of leukemia associated with another primary malignant lesion have been reported. In this study we reported the occurrence of a second primary neoplasm in 82 consecutive cases of chronic lymphocytic leukemia (CLL) admitted to the Istituto Nazionale Tumori of Milan from September 1962 to December 1978. In 16 of these (19.5%), an associated neoplasm was diagnosed subsequently (8 cases) or concurrently (8 cases) to CLL. Head and neck carcinomas and breast cancer had the highest incidence (5 and 3 cases, respectively). The results of this study further support the hypothesis that patients with CLL are prone to develop subsequent cancer. The defective cellular and humoral immunity in CLL may have an etiological role in the development of an additional primary malignancy. Although alkylating agents are known carcinogens in experimental animals and man, our results support the lack of a correlation between treatment with alkylating agents and incidence of second primary neoplasms, as demonstrated by Greene et al. (10).
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Schwartz GG, Klug MG. Incidence rates of chronic lymphocytic leukemia in US states are associated with residential radon levels. Future Oncol 2016; 12:165-74. [DOI: 10.2217/fon.15.275] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: Environmental risk factors for chronic lymphocytic leukemia (CLL) have not been consistently identified. An etiologic role for ionizing radiation in CLL is controversial. Because most of the ionizing radiation to which individuals are exposed comes from radon at home, we examined CLL incidence rates in relation to residential radon levels. Methods: We used population-based rates for CLL for US states from 2007 to 2011 and measurements of residential radon made by the US Environmental Protection Agency. Results: Incidence rates for CLL were significantly correlated with residential radon levels among whites (both genders together and each gender separately; p < 0.005) and among blacks (p < 0.05). Conclusion: We speculate that radon increases CLL risk and that the mechanisms may be similar to those by which radon causes lung cancer.
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Affiliation(s)
- Gary G Schwartz
- Department of Population Health, University of North Dakota School of Medicine & Health Sciences, Grand Forks, ND 58202, USA
| | - Marilyn G Klug
- Department of Family Medicine & Center for Rural Health, University of North Dakota School of Medicine & Health Sciences, Grand Forks, ND 58202, USA
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Ruchlemer R, Polliack A. Geography, ethnicity and “roots” in chronic lymphocytic leukemia. Leuk Lymphoma 2012; 54:1142-50. [DOI: 10.3109/10428194.2012.740670] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Omoti CE, Awodu OA, Bazuaye GN. Chronic lymphoid leukaemia: clinico-haematological correlation and outcome in a single institution in Niger Delta region of Nigeria. Int J Lab Hematol 2007; 29:426-32. [PMID: 17988297 DOI: 10.1111/j.1751-553x.2007.00888.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- C E Omoti
- Department of Haematology, University of Benin Teaching Hospital, Benin city, Nigeria.
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Abstract
The cold antibody autoimmune hemolytic anemias (AIHAs) are primarily comprised of cold agglutinin syndrome (CAS) and paroxysmal cold hemoglobinuria (PCH) but, in addition, there are unusual instances in which patients satisfy the serologic criteria of both warm antibody AIHA and CAS ("mixed AIHA"). CAS characteristically occurs in middle-aged or elderly persons, often with signs and symptoms exacerbated by cold. The responsible antibody is of the IgM immunoglobulin class, is maximally reactive in the cold but with reactivity up to at least 30 degrees C. Therapy is often ineffective, but newer agents such as rituximab have been beneficial in some patients. PCH occurs primarily in children, often after an upper respiratory infection. The causative antibody is of the IgG immunoglobulin class and is a biphasic hemolysin that is demonstrated by incubation in the cold followed by incubation at 37 degrees C in the presence of complement. Acute attacks are frequently severe but the illness characteristically resolves spontaneously within a few days to several weeks after onset and rarely recurs. Treatment consists of supportive care, with transfusions frequently being needed.
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MESH Headings
- Aged
- Anemia, Hemolytic, Autoimmune/diagnosis
- Anemia, Hemolytic, Autoimmune/drug therapy
- Anemia, Hemolytic, Autoimmune/immunology
- Child
- Child, Preschool
- Cold Temperature/adverse effects
- Hemoglobinuria, Paroxysmal/diagnosis
- Hemoglobinuria, Paroxysmal/drug therapy
- Hemoglobinuria, Paroxysmal/immunology
- Hemolysin Proteins/blood
- Hemolysin Proteins/immunology
- Hemolysis/immunology
- Humans
- Immunoglobulin A
- Immunoglobulin G
- Immunosuppressive Agents/therapeutic use
- Middle Aged
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Affiliation(s)
- Lawrence D Petz
- Pathology and Laboratory Medicine, University of California Los Angeles, StemCyte International Cord Blood Center, Arcadia, California, United States.
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de Faria JR, de Oliveira JS, Delbone de Faria RM, Silva MR, Goihman S, Yamamoto M, Kerbauy J. Prognosis related to staging systems for chronic lymphocytic leukemia. SAO PAULO MED J 2000; 118:83-8. [PMID: 10887382 DOI: 10.1590/s1516-31802000000400002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
CONTEXT Chronic lymphocytic leukemia (CLL) is a clonal lymphoproliferative disorder, characterized by B lymphocytic proliferation. CLL is the most frequent adult leukemia in Western countries, accounting for 25 to 30% of all white leukemic patients. OBJECTIVE To evaluate clinical and staging characteristics in prognosis of chronic lymphocytic leukemia. DESIGN Evaluation of clinical-staging data. SETTING Universidade Federal de São Paulo - Escola Paulista de Medicina / Universidade de Alfenas. SAMPLE 73 patients diagnosed from 1977 to 1994. MAIN MEASUREMENTS Sex, ethnic origin, age, lymphadenopathy, splenomegaly, hepatomegaly, three or more areas of lymphoid enlargement, hemoglobin (g/dl), lymphocytes/mm3, Platelets/mm3 RESULTS Mean survival of patients was 76 months, median age was 65 years, ranging from 33 to 87. Forty-four patients (60.3%) were male and 29 (39.7%) female. CONCLUSION The Binet system determined a better prognosis than Rai.
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Affiliation(s)
- J R de Faria
- Division of Hematology, Universidade de Alfenas, Minas Gerais, Brazil
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Bertoldero G, Scribano G, Podda L, Berti R, Amadori G. Occurrence of second neoplasms in chronic lymphocytic leukemia. Experience at Padua Hospital between 1979 and 1991. Ann Hematol 1994; 69:195-8. [PMID: 7948306 DOI: 10.1007/bf02215953] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
We report a retrospective study about the incidence of second neoplasms (SN) in patients affected by chronic lymphocytic leukemia (CLL) admitted to Padua Hospital between 1989 and 1991, comparing data with those of a similar population. We examined the records of 212 patients, finding in 19 of them 22 second neoplasms; the most common kind was lung cancer. There was an increased incidence of SN, without statistic significance if compared with all sites of cancers in the general population, especially during the first 2 years from the diagnosis of CLL. In accordance with the majority of authors, there is an unknown connection between the two diseases, but certainly independent of chemotherapy with alkylating agents.
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Affiliation(s)
- G Bertoldero
- School of Hematology, Clinica Medica 1, University of Padua, Italy
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Abstract
In recent years many subtypes of CLL and some CML variants have been recognized throughout the world by means of careful clinical, epidemiological, immunological, molecular biological and viral studies. Most striking has been the establishment of a close association between certain immunophenotypical subtypes of CLL and infection with HTLV-I and possibly HTLV-II. CLL has consistently been shown to have a strong genetic component and a low incidence among Asians, but a growing body of evidence also links this major leukaemia type with environmental factors including solvents, unidentified farming and other occupational exposures. In contrast, CML is characterized by few genetic associations, relatively homogenous world-wide distribution, greater frequency in Blacks than in Whites, little evidence of viral aetiology, and evidence that exposures to ionizing radiation, benzene and possibly other chemical agents are important aetiological factors. Most studies suggest that acquired rather than genetic factors are of greater importance in the aetiology of CML, but this conclusion is somewhat difficult to reconcile with the relatively small variation in incidence rates internationally. Common to both disorders in most populations are an increasing incidence with age, male predominance, and stability of incidence, survival and mortality over the years, exclusive of improved survival of CML following allogeneic bone marrow transplantation.
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Abstract
Hematologic dysfunction occurs commonly in patients with malignancy. Over half are anemic, often because of acute or chronic blood loss, marrow involvement by the malignancy, marrow suppressive effects of chemotherapy or radiation therapy, or because of the anemia of chronic disease. Less frequently, anemia may result from red cell aplasia, folate or B12 deficiency, hemolytic processes, or hypersplenism. Occasional patients may become polycythemic because of erythropoietin-producing tumors such as renal adenocarcinomas or cerebellar hemangiomas. Elevation of the white cell count is commonly seen, especially in patients with lung cancer. Monocytosis and thrombocytosis, which may be early signs of an underlying malignancy, are also very common and occur in up to half of patients. Thrombocytopenia is commonly a result of therapy or marrow replacement; a few patients may have a syndrome resembling immune thrombocytopenic purpura. Abnormalities of coagulation are present in many patients, and may lead to superficial or deep venous thromboses, pulmonary emboli, nonbacterial thrombotic endocarditis with arterial emboli, bleeding, or acute disseminated intravascular coagulation. A sound understanding of the potential hematologic complications that can result from the malignant process is essential to the clinician caring for cancer patients.
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Affiliation(s)
- R A Johnson
- Wilford Hall U.S.A.F. Medical Center, San Antonio, Texas
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Cartwright RA, Bernard SM, Bird CC, Darwin CM, O'Brien C, Richards ID, Roberts B, McKinney PA. Chronic lymphocytic leukaemia: case control epidemiological study in Yorkshire. Br J Cancer 1987; 56:79-82. [PMID: 3304389 PMCID: PMC2001663 DOI: 10.1038/bjc.1987.158] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
This is the second report of a large case control study of lymphoma/leukaemia occurring in Yorkshire during 1979-84, and deals with chronic lymphocytic leukaemia presenting either in its haematological (CLL) or more solid lymphomatous (malignant lymphoma-lymphocytic or MLL) forms. In all, 330 cases and 561 controls were interviewed. The results support the concept that CLL/MLL is a condition of multiple aetiologies with evidence for genetic predisposition through an excess of family cases, immune perturbation demonstrated by excessive previous skin diseases and phenylbutazone use, and viral involvement shown by links with infectious diseases and multiple sclerosis.
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MESH Headings
- Drug-Related Side Effects and Adverse Reactions
- England
- Female
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/epidemiology
- Leukemia, Lymphocytic, Chronic, B-Cell/etiology
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphoid/epidemiology
- Leukemia, Lymphoid/etiology
- Leukemia, Lymphoid/genetics
- Male
- Radiotherapy/adverse effects
- Risk
- Skin Diseases/complications
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Lishner M, Prokocimer M, Ron E, Shaklai M. Primary malignant neoplasms associated with chronic lymphocytic leukaemia. Postgrad Med J 1987; 63:253-6. [PMID: 3684832 PMCID: PMC2428158 DOI: 10.1136/pgmj.63.738.253] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The relationship between chronic lymphocytic leukaemia (CLL) and primary malignant neoplasms was evaluated using data from the Hematology Division in Beilinson Medical Center and the Israel Cancer Registry. The study population consisted of 81 patients diagnosed between 1962 and 1984. A total of 16 patients were found to have 21 malignant neoplasms in addition to their CLL. Excluding patients with nonmelanoma skin tumours, a 1.7 increased risk (statistically not significant) for developing second malignant neoplasms in CLL patients was detected. The only tumour which occurred significantly more than expected subsequent to CLL diagnosis was brain cancer. The coexistence of multiple cancers in the same patient was diagnosed in four of the patients. The results of this study further support the hypothesis that patients with CLL are prone to develop second neoplasms.
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Affiliation(s)
- M Lishner
- Division of Hematology, Beilinson Medical Center, Petah Tiqva, Israel
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Ben-Izhak C, Shechter Y, Tatarsky I. Significance of multiple types of antibodies on red blood cells of patients with positive direct antiglobulin test: a study of monospecific antiglobulin reactions in 85 patients. SCANDINAVIAN JOURNAL OF HAEMATOLOGY 1985; 35:102-8. [PMID: 3876592 DOI: 10.1111/j.1600-0609.1985.tb00808.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Blood samples from 85 patients with a positive direct antiglobulin test were tested with monospecific antiglobulin reagents: anti-IgG, anti-IgM, anti-IgA, and anti-C3. No typical pattern of antiglobulin reaction could be correlated with specific diseases except for the patients with methyldopa-induced positive direct antiglobulin test, all of whom had only IgG on their red blood cells. The presence of more than 1 type of antibody on red blood cells was associated with severe haemolysis. These patients responded less frequently to steroids, and in most of them no underlying disease could be found. Most patients with complement alone on red blood cells had no evidence of haemolysis, and when present it was never severe.
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Bernard SM, Cartwright RA, Bird CC, Richards ID, Lauder I, Roberts BE. Aetiologic factors in lymphoid malignancies: a case-control epidemiological study. Leuk Res 1984; 8:681-9. [PMID: 6471900 DOI: 10.1016/0145-2126(84)90016-x] [Citation(s) in RCA: 49] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
A prospective case-control study of the aetiologic factors involved in the production of lymphoid malignancies has been conducted within a defined geographical area covering six health districts in the Yorkshire Region. Among the aspects investigated were past medical events, occupations and certain social factors. A number of possible causal relationships have been identified including Jewish religion, past solvent exposure and ingestion of amphetamines, although the latter did not achieve statistical significance in this study. In addition several new associations have been identified, most notably with the occurrence of adult eczema/dermatitis and with treatment by radiation or steroids. The feasibility of conducting such a broadly based epidemiological investigation has been established.
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Deviri E, Bartal A, Goldsher M, Eliachar I, Steinitz R, Robinson E. Occurrence of additional primary neoplasms in patients with laryngeal carcinoma in Israel (1960-1976). Ann Otol Rhinol Laryngol 1982; 91:261-5. [PMID: 7092045 DOI: 10.1177/000348948209100306] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
One thousand-six-hundred and sixty cases of laryngeal cancer were diagnosed in Israel during the years 1960-1976. In 98 of these cases another primary cancer accompanied the laryngeal carcinoma. Patients whose second primary cancer was basal or squamous cell carcinoma of the skin were not included in this study. Therefore, the results reported here deal with 84 patients. The prevalence of multiple primary cancer in patients with laryngeal carcinoma was found to be 5%. Lung cancer is the other primary tumor accompanying laryngeal carcinoma most frequently (29% of the additional tumors) followed by colorectal and bladder cancers. Most of the additional tumors (83%) appeared in a metachronic form with an average time interval of six years. In most metachronic tumors laryngeal carcinoma appeared as the first tumor (86%). Eighty percent of the patients were dead by August 1978. The majority (74%) succumbed due to the additional tumor and only 4% died of laryngeal carcinoma.
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