scholarly journals Other Malignancies in Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma

2009 ◽  
Vol 27 (6) ◽  
pp. 904-910 ◽  
Author(s):  
Apostolia-Maria Tsimberidou ◽  
Sijin Wen ◽  
Peter McLaughlin ◽  
Susan O'Brien ◽  
William G. Wierda ◽  
...  
Keyword(s):  
Chronic Lymphocytic Leukemia ◽  
Survival Rates ◽  
Lymphocytic Leukemia ◽  
Cancer Center ◽  
Second Cancer ◽  
Small Lymphocytic Lymphoma ◽  
University Of Texas ◽  
History Of ◽  
Cox Analysis ◽  
The University

Purpose Other malignancies have been reported to occur with increased frequency in chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL). The aim of this study was to determine the frequency, outcomes, and factors associated with other cancers in patients with CLL/SLL. Patients and Methods We reviewed the records of consecutive patients with previously untreated CLL/SLL seen at The University of Texas M. D. Anderson Cancer Center from 1985 to 2005. The number of second cancers observed was compared with the number expected from the Surveillance, Epidemiology, and End Results database. Results Among 2,028 patients, 324 (16%) had a history of other cancers and 227 (11.2%) developed other malignancies during the follow-up period. Overall, 625 cancers were observed in 551 patients, including skin (30%), prostate (13%), breast (9%), melanoma (8%), lymphoma (8%), gastrointestinal (9%), lung (6%), and other cancers (17%). The risk of a second cancer was 2.2 times higher than the expected risk. The response rates in patients with and without a history of other cancers were 86% and 92%, respectively (P = .04), and the 5-year survival rates were 70% and 82%, respectively (P < .001). In Cox analysis, independent factors predicting development of new cancers were older age, male sex, and elevated levels of β2-microglobulin, lactate dehydrogenase, and creatinine. In patients who were treated for CLL/SLL, the treatment regimen did not affect the risk of subsequent cancer (P = .49). Conclusion Patients with CLL/SLL have more than twice the risk of developing a second cancer and an increased frequency of certain cancer types. Awareness of risk factors could permit early detection.

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

2007 ◽  
Vol 25 (29) ◽  
pp. 4648-4656 ◽  
Author(s):  
Apostolia M. Tsimberidou ◽  
Sijin Wen ◽  
Susan O'Brien ◽  
Peter McLaughlin ◽  
William G. Wierda ◽  
...  
Keyword(s):  
Chronic Lymphocytic Leukemia ◽  
Prognostic Score ◽  
Lymphocytic Leukemia ◽  
Cancer Center ◽  
Small Lymphocytic Lymphoma ◽  
Region Gene ◽  
Cox Models ◽  
Cytogenetic Abnormalities ◽  
University Of Texas ◽  
The University

Purpose Chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) are currently considered the same entity, but controversy remains over whether CLL and SLL should be treated similarly. We assessed whether characteristics of patients with CLL and SLL differ in ways other than the absolute lymphocyte count (ALC) and evaluated treatment outcomes and prognostic factors. Methods We searched the electronic database for patients with CLL or SLL who presented to The University of Texas M.D. Anderson Cancer Center (Houston, TX) between 1985 and 2005. We reviewed patient records to determine presenting characteristics, treatment, and clinical outcomes. Cox models using training and validation sets of patients and resampling methods were used to develop a model predicting survival. Results Among 2,126 consecutive CLL/SLL patients, 312 (15%) had ALC less than 5 × 109/L. Patients with ALC less than 5 × 109/L had lower rates of cytogenetic abnormalities (P = .0002) and higher rates of CD38-positive results (P = .0002) and had mutated immunoglobulin heavy-chain variable region gene status (P = .034). Rates of response, survival, and failure-free survival (FFS) were not different among ALC groups. Regimens that included rituximab and a nucleoside analog were associated with superior rates of response and FFS compared with other therapies, irrespective of ALC. Deletion 17p or 6q with or without other cytogenetic abnormalities, age at least 60 years, β2-microglobulin at least 2 mg/L, albumin less than 3.5 g/dL, and creatinine at least 1.6 mg/dL were each found to independently predict shorter survival and formed the basis of a scoring system. Conclusion Patients with CLL or SLL can be treated similarly. A new prognostic score is proposed.

Epstein-Barr Virus in Patients with Chronic Lymphocytic Leukemia.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 2113-2113
Author(s):  
Apostolia-Maria Tsimberidou ◽  
Michael J. Keating ◽  
Carlos Bueso-Ramos ◽  
Razelle Kurzrock
Keyword(s):  
Chronic Lymphocytic Leukemia ◽  
Epstein Barr Virus ◽  
Lymphocytic Leukemia ◽  
Cancer Center ◽  
University Of Texas ◽  
Barr Virus ◽  
Ebv Infection ◽  
Number Of Patients ◽  
Epstein Barr ◽  
The University

Abstract Purpose: The Epstein-Barr virus (EBV) is implicated in the development of Richter’s transformation in patients with chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL). The objective of this study was to assess the incidence and the clinical significance of EBV in patients with CLL/SLL. Patients and Methods: Patients with CLL/SLL who presented at The University of Texas M. D. Anderson Cancer Center over a two-year period, and had available marrow paraffin blocks were studied for evidence of EBV infection using a highly specific in-situ hybridization assay for detection of EBV encoded RNA (EBERs). Results were analyzed in relation to other presenting characteristics and outcome. Results: Thirty-two patients were examined. EBERs were detected in 12 of 32 (38%) CLL/SLL marrows versus 0 of 20 normal marrows (p = 0.002). EBERs were observed in sporadic granulocytes alone or in addition to its presence in lymphocytes in nine of the twelve EBV-positive patients. EBERs were detected less frequently in patients with Rai stage 0-1 disease (20%) compared with Rai stage 2–4 (66%; p=0.008); EBER-positive patients tended to have higher lactate dehydrogenase (LDH) levels (p=0.053). The 10-year survival rate was 22% versus 58% for patients with and without discernible EBERs (log-rank, p=0.08). Figure Figure Conclusions: Evidence of EBV infection was found in 38% of CLL/SLL patients assessed. Despite the small number of patients tested, discernable EBERs were significantly more common in individuals with more advanced Rai stage, and there was a trend toward shorter survival in patients in whom EBV EBERs were discerned. Larger studies are needed to determine the prognostic value and role of EBV infection in patients with CLL/SLL.

Cervical and colorectal cancer screening among breast cancer (BrCa) survivors followed in either a breast center (BC) or a breast survivorship clinic (SvC) at The University of Texas M.D. Anderson Cancer Center

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e20506-e20506
Author(s):  
A. L. Olson ◽  
T. Bevers ◽  
M. Guzman ◽  
R. L. Theriault ◽  
G. N. Hortobagyi ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Cancer Screening ◽  
Colon Cancer Screening ◽  
Cancer Center ◽  
Nursing Documentation ◽  
University Of Texas ◽  
Screening Strategies ◽  
Surgical Evaluation ◽  
History Of ◽  
The University

e20506 Background: An essential component of cancer survivorship care includes the prevention and early detection of new cancers. We sought to determine if documentation of appropriate cervical and/or colon cancer screening differed between BrCa survivors followed in our BC (patients < 5 yrs from diagnosis of invasive BrCa or with active BrCa issues) and those seen in our SvC (patients with history of DCIS or ≥ 5 yrs from invasive BrCa diagnosis). Methods: IRB approval was obtained for this retrospective study. 5,982 BrCa survivors were seen for follow-up in our BC or SvC between 7/1/05 and 12/31/06. 2,811 BC patients and 1191 SvC patients (total = 4,002) met inclusion criteria: 1) not receiving chemotherapy, radiation, or undergoing surgical evaluation; 2) no evidence of recurrent BrCa; 3) ≥ 12 months from BrCa diagnosis, 4) no active GYN or GI complaints. Results: BrCa survivors followed our SvC were significantly more likely to have provider documentation of both cervical and colon cancer screening than those followed in our BC (72% versus 22.7%, and 68.4% versus 14.5%, respectively; both p values <0.001). Although nursing documentation of cervical cancer screening is required in both centers, SvC patients were more likely to have this documented than those in the BC (95.3% versus 56.5%, respectively; p <0.001). Nursing documentation of colon cancer screening is required in SvC (84.2% documented) but not in the BC (3.5% documented). Conclusions: BrCa survivors receiving care in our survivorship clinic were more likely to have nursing or provider documentation of cervical and/or colon cancer screening. Strategies that trigger documentation of non-BrCa screening take advantage of the “teachable moment” during a routine visit- thereby promoting the long-term health of cancer survivors. No significant financial relationships to disclose.

scholarly journals Minimal Residual Disease in Chronic Lymphocytic Leukemia: Highlights From SOHO 2020

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Lisa Nodzon, PhD, ARNP, AOCNP
Keyword(s):  
Minimal Residual Disease ◽  
Residual Disease ◽  
Lymphocytic Leukemia ◽  
Cancer Center ◽  
Clinical Implications ◽  
University Of Texas ◽  
Key Points ◽  
Md Anderson ◽  
The University ◽  
Minimal Residual

At the 2020 Society of Hematologic Oncology (SOHO) Annual Meeting, William Wierda, MD, PhD, of The University of Texas MD Anderson Cancer Center, described the clinical implications of measuring minimal residual disease. Lisa Nodzon, PhD, ARNP, AOCNP®, of Moffitt Cancer Center, summarizes the key points for advanced practitioners.

scholarly journals Synchronous Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma and Metastatic Squamous Cell Carcinoma of the Cervix Involving the Coronary Arteries Leading to Acute Myocardial Infarction

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Michelle Bernshteyn ◽  
Alexandria Smith-Hannah ◽  
Amit S. Dhamoon
Keyword(s):  
Myocardial Infarction ◽  
Squamous Cell Carcinoma ◽  
Case Report ◽  
Chronic Lymphocytic Leukemia ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Lymphocytic Leukemia ◽  
Small Lymphocytic Lymphoma ◽  
Metastatic Squamous Cell Carcinoma ◽  
History Of

A 66-year-old woman presented to the hospital with a one-month history of shortness of breath, fatigue, and postmenopausal vaginal bleeding and a one-week history of chest pain. This case report discusses the rare synchronous occurrence of two different malignancies in the setting of non-ST segment elevation myocardial infarction and the relation between these unfortunate events. Besides the case presented in this report, there have been only 13 reported cases of synchronous chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) associated with metastatic squamous cell carcinoma. While it is well known that malignancy causes a hypercoagulable state, there are other mechanisms which may have contributed to the patient’s myocardial ischemia including external vascular compression, tumor lysis syndrome, and anemia. This case report discusses the rarity of synchronous malignancies but the importance of understanding and consideration of cardiac events in this population.

scholarly journals De novo deletion 17p13.1 chronic lymphocytic leukemia shows significant clinical heterogeneity: the M. D. Anderson and Mayo Clinic experience

Blood ◽  
2009 ◽  
Vol 114 (5) ◽  
pp. 957-964 ◽  
Author(s):  
Constantine S. Tam ◽  
Tait D. Shanafelt ◽  
William G. Wierda ◽  
Lynne V. Abruzzo ◽  
Daniel L. Van Dyke ◽  
...  
Keyword(s):  
Chronic Lymphocytic Leukemia ◽  
Mayo Clinic ◽  
De Novo ◽  
Survival Rates ◽  
Variable Region ◽  
Lymphocytic Leukemia ◽  
Cancer Center ◽  
Clinical Heterogeneity ◽  
Purine Analogues ◽  
Asymptomatic Patients

To determine the clinical fate of patients with de novo deletion 17p13.1 (17p−) chronic lymphocytic leukemia (CLL), we retrospectively studied the outcome of 99 treatment-naive 17p− CLL patients from the M. D. Anderson Cancer Center (n = 64) and the Mayo Clinic (n = 35). Among 67 asymptomatic patients followed for progression, 53% developed CLL requiring treatment over 3 years. Patients who had not progressed by 18 months subsequently had stable disease, with 3 of 19 patients progressing after follow-up of up to 70 months. Risk factors for progressive disease were Rai stage of 1 or higher and unmutated immunoglobulin variable region heavy chain (IgVH). The overall survival rate was 65% at 3 years. Rai stage 1 or higher, unmutated IgVH, and 17p− in 25% or more of nuclei were adverse factors for survival. The 3-year survival rates of patients with 1 or fewer, 2, and 3 of these factors were 95%, 74%, and 22%, respectively (P < .001). Response rates to therapy with rituximab (n = 6); purine analogues and rituximab (n = 25); and purine analogues, rituximab, and alemtuzumab (n = 16) combinations were 50%, 72%, and 81%, respectively. Patients with 17p− CLL exhibit clinical heterogeneity, with some patients experiencing an indolent course. Survival can be predicted using clinical and biologic characteristics.

scholarly journals Composite Thymoma and Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma Involving the Anterior Mediastinum

2003 ◽  
Vol 127 (2) ◽  
pp. e76-e79
Author(s):  
Joseph D. Khoury ◽  
Hesham M. Amin ◽  
Jeffrey L. Jorgensen ◽  
Mary L. Ostrowski ◽  
M. G. Kim Bloom ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Chronic Lymphocytic Leukemia ◽  
Peripheral Blood ◽  
Bone Marrow Aspiration ◽  
Anterior Mediastinum ◽  
Lymphocytic Leukemia ◽  
Anterior Mediastinal Mass ◽  
Differential Count ◽  
Small Lymphocytic Lymphoma ◽  
History Of

Abstract Simultaneous involvement of the anterior mediastinum by thymoma and B-cell chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), to our knowledge, has not been previously reported. We describe a composite tumor composed of thymoma and CLL/SLL incidentally discovered in a 62-year-old man who had no history of malignant diseases or immunologic disorders. The preoperative peripheral blood specimen showed a normal complete blood cell count and differential count. The diagnosis was established by histologic examination and immunophenotypic studies of the surgically excised anterior mediastinal mass. Postoperatively, bone marrow aspiration and biopsy specimens showed morphologic evidence of CLL/SLL, and the presence of neoplastic cells in peripheral blood and bone marrow was confirmed by flow cytometry immunophenotypic analysis.

scholarly journals An Unusual Presentation of CLL/SLL on Mammography: Case Report

2020 ◽  
Author(s):  
Anas Mohamed ◽  
Ahmed Younes ◽  
John Stephen Stalls ◽  
Aisha Kousar ◽  
Tian Li
Keyword(s):  
Case Report ◽  
Chronic Lymphocytic Leukemia ◽  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Contralateral Breast ◽  
Lymphocytic Leukemia ◽  
Small Lymphocytic Lymphoma ◽  
History Of

Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) of the breast is rare. We report a 59-year-old female with remote history of ductal carcinoma in situ treated with radiation and tamoxifen, who was recently diagnosed with CLL/SLL of contralateral breast after a localized suspicious cluster of masses was detected on routine mammography.

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