scholarly journals Incidence of Non-Melanoma Skin Cancers in Patients with Chronic Lymphocytic Leukaemia: A Retrospective Study in a Bay of Plenty, New Zealand Population

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 4692-4692
Author(s):  
Andrew Weston ◽  
Marie Hughes ◽  
Gillian Corbett ◽  
Neil Graham ◽  
Franz Strydom
Keyword(s):  
New Zealand ◽  
Chronic Lymphocytic Leukaemia ◽  
Cancer Registry ◽  
Lymphocytic Leukaemia ◽  
Whole Body ◽  
Control Group ◽  
Skin Damage ◽  
Skin Cancers ◽  
Increased Risk ◽  
Melanoma Skin

Abstract Background/Aims: Chronic lymphocytic leukaemia (CLL) incurs an increased risk of developing second primary malignancies (SPMs). The pathogenesis underpinning this increased SPM risk is attributable to synergism between genetic aberrations, chronic immune suppression / dysfunction and CLL treatments. Specifically, CLL associated skin cancer is a well-documented phenomenon, with common malignancies such as squamous (SCC) and basal cell (BCC) carcinomas occurring at higher frequencies in CLL patients and are often of a more aggressive phenotype. The incidence of non-melanoma skin cancers (NMSCs) among New Zealand CLL patients is unknown, as NMSCs are not required to be reported to the New Zealand Cancer Registry. Accordingly, this study aimed to analyse the incidence of NMSC in CLL patients from the Bay of Plenty region of New Zealand. Methods: We conducted a retrospective analysis of 213 CLL patients, who were referred to Bay of Plenty District Health Board (BOPDHB) between 2015 and 2020, for the occurrence of SPMs. Clinical notes were reviewed for the demographics of sex, age at time of CLL diagnosis, CLL treatments received and occurrence and type of NMSCs. A control group of 76 patients referred to BOPDHB haematology, for anaemia or thrombocytopenia, of which the cause subsequently remained unknown and was not associated with lymphoproliferative disease, was reviewed for primary malignancy (PM), occurrence and type. NMSC incidence was also compared to a local data, on overall NMSC incidence in the general Bay of Plenty population, in 2015. Results: The predominant SPM types occurring in this CLL patient group were NMSCs. A total of 249 and 170 histological diagnoses of SCC and BCC were made in our group of CLL patients, respectively. Of the 213 CLL patients, 48.8% had a diagnosis of at least one NMSC, with median time between CLL and NMSC diagnosis of 5 years (range, -6 to 19 years). CLL patients that were diagnosed with NMSC developed a mean number of 3.93 ± 2.94 separate lesions, compared to 2.6 ± 1.7 lesions in our control population. Note: comparison of NMSC incidence data between CLL group and Bay of Plenty population Conclusion: Patients with CLL are at increased risk of developing multiple NMSC lesions. Therefore, we believe CLL patients should be assessed by dermatologists or general practitioners for whole-body skin examination, 6 monthly following their CLL diagnosis. This strategy promotes early diagnosis, and patient education on importance of sun protection strategies to reduce NMSC risk. This is essential to the ongoing care of CLL patients in a NZ context, given the increased incidence of NMSC associated with CLL, in combination with the high levels of UV exposure and skin damage among the NZ general population. This study also highlights how NMSC disease burden is likely to be significantly underestimated due to a lack of data collection on these malignancies by the New Zealand Cancer Registry. Disclosures No relevant conflicts of interest to declare.

Metabolic Syndrome and Its Components are Linked with Increased Risk of Non-Melanoma Skin Cancers in Iranian Subjects: A Case-Control Study

2021 ◽  
pp. 1-9
Author(s):  
Fatemeh Rezaiian ◽  
Sayed Hossein Davoodi ◽  
Bahareh Nikooyeh ◽  
Amir Houshang Ehsani ◽  
Ali Kalayi ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Case Control Study ◽  
Case Control ◽  
Skin Cancers ◽  
Increased Risk ◽  
Control Study ◽  
Melanoma Skin

Increased risk of chronic lymphocytic leukaemia among cancer survivors in the Netherlands: increased detection, causal factors or both?

2013 ◽  
Vol 93 (1) ◽  
pp. 157-162 ◽  
Author(s):  
E. C. van den Broek ◽  
L. Liu ◽  
E. F. M. Posthuma ◽  
M. L. G. Janssen-Heijnen ◽  
J. W. W. Coebergh ◽  
...  
Keyword(s):  
The Netherlands ◽  
Cancer Survivors ◽  
Chronic Lymphocytic Leukaemia ◽  
Lymphocytic Leukaemia ◽  
Causal Factors ◽  
Increased Risk

scholarly journals High Carbohydrate 19-9 Antigen Serum Levels in Patients with Nonmelanoma Skin Cancer and Primary Occult Cancer

Biomedicines ◽  
2020 ◽  
Vol 8 (8) ◽  
pp. 265 ◽  
Author(s):  
Giulia Malaguarnera ◽  
Saverio Latteri ◽  
Roberto Madeddu ◽  
Vito Emanuele Catania ◽  
Gaetano Bertino ◽  
...  
Keyword(s):  
Cell Carcinoma ◽  
Predictive Value ◽  
Case Control Study ◽  
Matched Control ◽  
Serum Levels ◽  
Normal Range ◽  
Skin Cancers ◽  
Increased Risk ◽  
Control Study ◽  
Melanoma Skin

Background: Non-melanoma skin cancers (NMSC), despite having a favourable prognosis, present an increased risk of occult malignancies. The aim of this study was the evaluation of the usefulness of the mucinous marker carbohydrate 19-9 antigen (CA 19-9) in the diagnosis of occult cancers. (1) Patients and Methods: This is a case control study in which 480 patients with NMSC and 480 matched control subjects with dermatitis were enrolled; 208 patients with NMSC showed upper-normal CA 19-9 values, and 272 showed under-normal CA 19-9 values. (2) Results: The 208 patients positive for CA 19-9 included 87 with basal cell carcinoma (BCC) and 121 with squamous cell carcinoma (SCC). The 272 patients negative for CA 19-9 included 107 with BCC and 165 with SCC. For the SCC patients, CA 19-9 serum levels were significant in 121 of the patients (positive), 66 of which were affected by cancer; CA 19-9 was within the normal range in 165 patients, of which 30 were diagnosed with cancer. In the SCC patients, the CA 19-9 sensitivity was 68%, the specificity was 70%, the positive predictive value (PPV) was 54% (95%) and the negative predictive value (NPV) was 81%. In the BCC patients, the CA 19-9 sensitivity was 70%, the specificity was 66%, the PPV was 48% and the NPV was 83%. In the dermatitis patients (controls), we observed 121 patients that were CA 19-9 positive, with 15 malignancies, and 359 CA 19-9-negative patients, with three malignancies. (3) Conclusions: To confirm the association between CA 19-9 and an elevated risk of malignancies in NMSC, prospective cohort studies should be performed.

Consolidation with Alemtuzumab in First Remission Induces Pronounced MRD Reduction and Clinical Remissions - Update on a Randomized Phase III Trial of the German CLL Study Group (GCLLSG).

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 2506-2506 ◽  
Author(s):  
Matthias Ritgen ◽  
C. Schweighofer ◽  
Günther Fingerle-Rowson ◽  
Barbara Eichhorst ◽  
Raimunde Busch ◽  
...  
Keyword(s):  
Chronic Lymphocytic Leukaemia ◽  
Late Stage ◽  
Clinical Remission ◽  
Lymphocytic Leukaemia ◽  
Phase Iii ◽  
Remission Induction ◽  
Control Group ◽  
Consolidation Therapy ◽  
Phase Iii Trial

Abstract The monoclonal antibody alemtuzumab is known to be effective in combination or alone in patients with late stage chronic lymphocytic leukaemia. Flow cytometric studies on minimal residual disease (MRD) showed the high potency beyond clinical response criteria even in late stage chronic lymphocytic leukaemia (CLL). The aim of the phase III trial of the GCLLSG was to investigate the role of alemtuzumab as consolidation therapy in CLL patients in first clinical remission after fludarabin (F) or F plus cyclophosphamide (FC). Patients in partial or complete clinical remission were randomized to either arm A (alemtuzumab 3 x 30 mg i.v. for up to 12 wks) or no further treatment (arm B). From 21 eligible patients 11 (1CR, 1 nPR, 9PR) were randomized to arm A. All patients received standard infection prophylaxis with famciclovir and trimethoprim/sulfamethoxazole. Before, at 6 and 12 weeks after start of consolidation therapy and regulary during follow up blood and bone marrow samples were send for molecular MRD assessment by allele specific real time PCR. The PCR allowed MRD assessment with a sensitivity of at least 10E-4 in 11 eligible cases. Results: MRD analysis showed clear reduction of CLL content by first line treatment to a median MRD level of 2.2E-3. Short after alemtuzumab treatment all treated patients showed pronounced MRD reduction to a median MRD level of 5.0E-5. During molecular follow-up median MRD level remained below 1E-4 for one year with a tendency to increase afterwards. After a median follow-up of 31.3 months from start of initial treatment occurred one relapse in the treatment arm compared to 7 of 10 in arm B. The median progression free survival (PFS) calculated from start of consolidation therapy was significantly shorter in the control group versus the treatment group (pfs 25.2; p= 0.04). Nevertheless due to severe acute infections (CTC III and IV) this study had to be stopped prematurely. Conlusion: The addition of alemtuzumab as a consolidation regimen after remission induction by F or FC is highly effective and leads to sustained MRD reduction below 10E-4. This translates into significant improved clinical outcome even in this small patient cohort compared to the control group. Encouraged by the molecular responses the GCLLSG initiated a new phase I/II trial as a dose finding study in CLL patients after F based induction of clinical remission.

Chronic Lymphocytic Leukaemia Has a More Aggressive Phenotype in Asians Compared to Caucasians.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 4965-4965
Author(s):  
Belinda Austen ◽  
Chaminda Gunawardana ◽  
Guy Pratt ◽  
Farooq Wandroo ◽  
Abe Jacobs ◽  
...  
Keyword(s):  
Overall Survival ◽  
Chronic Lymphocytic Leukaemia ◽  
Lymphocytic Leukaemia ◽  
Age Of Onset ◽  
Western World ◽  
Control Group ◽  
Aggressive Phenotype ◽  
Racial Origin ◽  
Asian Patients ◽  
Younger Age

Abstract Chronic lymphocytic leukaemia (CLL) is the commonest leukaemia in the western world with an incidence of 3 per 100,000. The precise aetiology remains obscure but there is clear evidence for a genetic predisposition. CLL has a seven-fold increased incidence amongst relatives of index cases compared to controls and the disease is also more common in males. These genetic subgroups can also determine phenotype as familial CLL has a younger age of onset and increased association with second malignancies compared to sporadic cases. Similarly, CLL is more aggressive and more frequently requires treatment in males in comparison to female patients. The incidence of CLL also varies according to racial origin and has been found to be up to 20-fold less common in Japanese and Asian populations compared to Caucasian populations. However, it is not known whether or not there is also phenotypic variation in CLL patients according to racial origin. We studied 29 Asian patients with a diagnosis of CLL and compared disease characteristics with a control group of 277 Caucasians. We found that CLL in Asians was diagnosed at a younger age (median age 62yr in Asians vs 70yr Caucasians, p=0.001) and was also more common in males (M:F Asians 3.1:1; Caucasians 1.3:1, p=0.023). No association was seen between racial origin and either IGVH status or CD38 status. Interestingly, we also found that the Asian population had a more aggressive clinical phenotype as indicated by a shorter time to the requirement of first treatment (TTFT) (p=0.019). This observation was independent of both age and gender. Although no difference was seen in overall survival between the two groups, ‘non-leukaemia related’ deaths were more common in the older Caucasian population. 27.5% of Caucasian deaths occurred in patients who had never required treatment for CLL whereas no deaths occurred among untreated Asian patients, for whom the primary cause of death was progressive leukaemia. The failure to observe a difference in overall survival was therefore partly accounted for by an increase in non-leukaemia related deaths in Caucasians. In conclusion, we have shown that there are phenotypic differences in CLL patients according to the racial origin. CLL in Asian patients occurs at a younger age and is associated with a more aggressive phenotype. The mechanisms underlying these observations are unknown but warrant further investigation.

Vanilloid Receptor (TRPV1) Expression on the Neoplastic B-Cell Lymphocytes in Patients with Chronic Lymphocytic Leukaemia.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 4955-4955
Author(s):  
Jaroslaw Piszcz ◽  
Slawomir Ziarko ◽  
Janusz Kloczko ◽  
Piotr Radziwon ◽  
Eliza Blusiewicz ◽  
...  
Keyword(s):  
Chronic Lymphocytic Leukaemia ◽  
B Cell ◽  
Peripheral Blood ◽  
Concentration Ratio ◽  
Lymphocytic Leukaemia ◽  
Vanilloid Receptor ◽  
Control Group ◽  
Study Group ◽  
Newly Diagnosed ◽  
Vanilloid Receptors

Abstract Background: Endocannabinoids take part in physiology of neural and immune system. Last data showed that these compounds and their receptors play an important role in proliferation and apoptosis of different neoplastic cells. Cannabinoids were shown to increase the apoptosis in human neoplastic cells through a number of mechanisms including vanilloid receptors (Sanchez et al. 1998, Maccarone et al. 2000). The vanilloid receptor family of cation channels includes the capsaicin-sensitive, proton- and heat-activated vanilloid receptor type I (TRPV1). Furthermore Saunders et al. (2006) showed that TRPV1 are expressed on normal lymphocytes in human peripheral blood. Aims: The aim of our study was the assessment of receptor TRPV1 mRNA expression in the lymphocytes B derived from patients with newly diagnosed chronic lymphocytic leukaemia. Material and methods: The study group contains newly diagnosed, untreated adult patients with B-cell chronic lymphocytic leukaemia; 11 males and 10 females, aged from 46 to 74. The patients were in A-C stage according to Binet. We used 13 samples from healthy donors as a control group. The isolation of mononuclear cells from peripheral blood was carried out with the use of density centrifugation method. The resolution of mononuclear cell population to lymphocytes B subpopulation was done with negative isolation method utilizing magnetic microballs (Dynal). Total RNA was isolated from B-lymphatic cells of which 10ng was used in each reaction. Quantitative RT-PCR was carried out with the use of Light Cycler (Roche) and respective commercial kits. The nucleotides sequence of the studied receptor and parameters of the amplification process were based on method previously described by Qiao et al (2003). We used house keeping gene hexose-6-phosphate dehydrogenase (glucose 1-dehydrogenase) (G6PDH) as a reference gene. Amplification product was sequenced by ABI PRISM (Applied Biosystem). All results are presented as a mean concentration ratio of TRPV1 to G6PDH mRNA ± standard error. Statistical analysis was performed using Shapiro-Wilk, non parametric U Mann-Whitney Tests. Results: We found that concentration ratio of studied transcript was significantly lower in the study group in comparison to the control group (0,048± 0,012 vs. 106,836± 40,215 respectively. We found no differences between the subgroups irrespectively of gender, age, stage of the disease and some prognostic factors (LDH, lymphocyte doubling time, β2-microglobulin). Conclusions: The results confirm the existence of vanilloid receptors on the lymphocytes B of healthy individuals and for the first time show presence of this type of receptors in CLL group. The lower level of TRPV1 transcripts in the group of patient may suggests their potential role in the process of leukemic transformation. Thus the effect of endocannabinoids through this receptor may be altered in CLL. However, further studies are required to elucidate the nature of relationship between this type of receptor and neoplastic development of CLL.

Chronic Lymphocytic Leukemia-Associated Chromosomal Abnormalities and Risk of Secondary Malignancies

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 5636-5636
Author(s):  
Shahzad Raza ◽  
Paul J Hampel ◽  
Belal Firwana ◽  
Zhen Wang ◽  
Yasar Shad ◽  
...  
Keyword(s):  
Overall Survival ◽  
Chromosomal Abnormalities ◽  
Lymphocytic Leukemia ◽  
Secondary Malignancy ◽  
Secondary Malignancies ◽  
Skin Cancers ◽  
Increased Risk ◽  
Trisomy 12 ◽  
13Q Deletion ◽  
Melanoma Skin

Abstract Introduction: Incidence of secondary malignant neoplasm in patients with chronic lymphocytic leukemia (CLL) is already established. Genetic predisposition has been considered to be a possible contributory factor for the preponderance of second cancers in this population. In the present study, we examined the frequency, characteristics, and clinical outcomes of secondary malignancies in patients with CLL based on their Interphase fluorescence in situ hybridization (FISH) panel. Methods: We reviewed the medical records of consecutive patients with CLL observed or treated at Ellis Fischel Cancer Center during the period from 2007-2014. We collected demographic data, CLL Rai stage, treatment history, Interphase fluorescence in situ hybridization (FISH) panel results and the presence of a secondary malignancy (skin cancers, solid tumors and hematologic malignancy excluding CLL transformation).Our aim was to investigate the association between secondary malignancy and chromosomal abnormalities and other risk factors using Chi2test for categorical variables and Wilcoxon rank-sum test for continuous variables. Cox proportional hazard models and logistic regression models were used to evaluate risk factors of developing secondary malignancy and overall survival. Results: We identified 142 CLL patients who were either observed (n=62) or had a history of treatment (n=80) for CLL. 67% were male and 33% were female. 85% of patients were Caucasians, 10% African Americans, and 5% other. Familial CLL was present in 6% of cases. 51% of patients were non-smokers. 5% of patients had cancers preceding the diagnosis of CLL (non-melanoma skin cancers=3, melanoma=1, Hodgkin's lymphoma=1, Prostate=2). 28% of patients developed secondary malignancies after the diagnosis of CLL; among them non-melanoma skin cancers were the most common (78%), followed by cutaneous melanoma (9.5%) and papillary thyroid cancer (4.7%). Other malignancies included lung (2.3%), kidney (2.3%), prostate (2.3%) and ocular melanoma (2.3%). 12% patients had aggressive non-melanoma recurrent skin cancers that require multiple treatments along-with systemic therapy for progressive CLL. CLL-FISH panel at diagnosis was available in 98 patients. Among these patients,13q deletion was present in 45%. Within the 13q deletion group, secondary malignancy was noted in 50% during a median follow up of 7 years. All cases of papillary thyroid cancers were also present in 13q deletion. In contrast, 11q deletion was detected in 15% and trisomy 12 in 18% of patients with incidence of secondary malignancy 40% and 10%, respectively. No solid malignancy other than skin was identified in the 11q deletion and trisomy 12 groups. 17p deletion was present in 5% of cases and 60% of 17p deletion cases had secondary cancers (skin 80%). Normal FISH panel was present in 17% cases and 20% of normal FISH had secondary malignancy (solid 10%, skin 10%). The median overall survival time is 6 years for the entire cohort (IRQ: 3-9 years). Secondary malignancy was associated with worse overall survival (OS) (HR=0.57, 95% CI:0.33-0.98, p=0.04) compare to patients who did not have secondary malignancy. The risk of secondary malignancy is increased in patients with advanced age (OR=1.05, 95% CI:1.00-1.10, p=0.04) and in those who were treated with alkylating agent for CLL OR=6.62, 95% CI:2.08-21.03, p=0.001. However, there were no significant difference on risk of developing secondary malignancy based on specific chromosomal FISH result, Rai stage, smoking, family history and gender. Conclusion: Secondary malignancies are frequent in patients with detectable chromosome abnormality on FISH panel. However, the increased risk of secondary malignancy does not correlate with specific cytogenetic abnormality. Non melanoma skin cancers are exceedingly common in CLL patients and carries aggressive couse in progressive CLL patients. Larger studies are required to identify subtype of CLL based on integrated mutational and cytogenetic subgroup that are at increased risk of specific secondary malignancies. Disclosures No relevant conflicts of interest to declare.

scholarly journals Stomach Cancer in a Patient with Chronic Lymphocytic Leukaemia

2019 ◽  
Vol 9 (2) ◽  
pp. 125-131
Author(s):  
R. A. Maier ◽  
B. A. Bakirov ◽  
M. V. Timerbulatov
Keyword(s):  
Chronic Lymphocytic Leukaemia ◽  
Stomach Cancer ◽  
Lymphocytic Leukaemia ◽  
Treatment Protocol ◽  
Malignant Neoplasm ◽  
Malignant Neoplasms ◽  
Increased Risk ◽  
Chemotherapy Protocol ◽  
Gastric Endoscopy ◽  
Stomach Adenocarcinoma

Introduction. Chronic lymphocytic leukaemia (CLL) is a malignant clonal lymphoproliferative disorder characterised by the accumulation of atypical mature CD5/CD19/CD23-positive B lymphocytes, predominantly in blood, bone marrow, lymph glands, liver and spleen. Chemotherapy protocols with the inclusion of nucleotide analogues, alkylating drugs and monoclonal antibodies are currently the standard of treatment. FCR (fludarabine, cyclophosphamide, rituximab) is one of the most effective protocols. CLL may lead to various immunologic disorders resulting in an increased risk of a malignant neoplasm. This paper aims to present a demonstration of a case of the combination of chronic lymphocytic leukaemia and stomach cancer, and an attempt to establish — based on literature data — a link between the diagnosed stomach adenocarcinoma and the main disease.Materials and methods. Authors have analysed the case history, laboratory and instrumental data and the treatment of a patient with chronic lymphocytic leukaemia and stomach adenocarcinoma.Results and discussion. The patient E., 63 yo, was diagnosed with chronic lymphocytic leukaemia in 2016. The patient was started on FCR chemotherapy protocol (Fludarabine, 70 mg days 2-4 of CT, Endoxan 500 mg days 2-4 of the cycle, Rituximab 700 mg day 1 od CT) in June 2018. When the patient came to the BSMU hospital for a chemotherapy cycle in August 2018, gastric endoscopy was performed; tissue pathology examination resulted in the diagnosis of stomach adenocarcinoma. A concilium of surgeons, oncologists and haematologists made a decision to perform a gastrectomy with the oesophageal resection and Roux anastomosis.Conclusion. Having used a clinical case as an example and reviewed available literature, the authors have demonstrated that either CLL or the immunosuppressed status served as the causal factors for the development of the adenocarcinoma. The development of stomach adenocarcinoma in patients with chronic lymphocytic leukaemia makes the course and outcome of the main disease much more severe. A decision regarding the management strategy for such patients has to make individually every time, taking into account the severity of the oncological disease; this impacts on the choice of the treatment protocol. All the cases of spontaneous remissions in patients with lymphocytic leukaemia must be screened extensively in order to facilitate early diagnosis of malignant neoplasms.

scholarly journals PSORIASIS AND CANCER: A SYSTEMIC REVIEW

2021 ◽  
pp. 42-44
Author(s):  
Fiallos Castro María Belén ◽  
Armijos Romero Noella Lisbeth ◽  
Rodríguez Lema Andrea Carolina ◽  
Araujo Saa Alvaro Paul ◽  
Rivera García Soraya Maricela
Keyword(s):  
Cancer Risk ◽  
Meta Analysis ◽  
Systemic Review ◽  
Ultraviolet A ◽  
Skin Cancers ◽  
Increased Risk ◽  
Large Heterogeneity ◽  
Risk Of Cancer ◽  
The Relationship ◽  
Melanoma Skin

The relationship between psoriasis and increased cancer risk is debated.The aim of this study was to evaluate if there is an increase in the background risk of cancer in psoriasis patients compared with the general population.There was a large heterogeneity in studies assessing cancer risk in psoriasis preventing from including all studies in meta-analysis. This systematic literature review shows a small increased risk of some solid cancers in psoriasis,especially those linked to alcohol drinking and cigarette smoking. A higher risk of non-melanoma skin cancers, especially squamous cell carcinoma, is shown, mainly due to previous exposure to 8-methoxypsoralen-ultraviolet-A (PUVA), ciclosporin and possibly methotrexate

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