Risk factors for development of a second lymphoid malignancy in patients with chronic lymphocytic leukaemia

Kami Maddocks-Christianson, Susan L. Slager, Clive S. Zent, Megan Reinalda, Timothy G. Call, Thomas M. Habermann, Deborah A. Bowen, James D. Hoyer, Susan Schwager, Diane F. Jelinek, Neil E. Kay, Tait D. Shanafelt

Research output: Contribution to journalArticlepeer-review

67 Scopus citations


Previous studies suggested that patients with chronic lymphocytic leukaemia (CLL) are at a three- to fivefold increased risk of developing a second lymphoproliferative disorder (LPD). This observational cohort study used the Mayo Clinic CLL Database to identify factors associated with developing a second LPD. A second LPD was identified in 26 (2.7%) of 962 CLL patients during a median follow-up of 3.3 years. Diffuse large B-cell lymphoma was the most common subtype of secondary LPD (12 of 26 cases). Patients previously treated for CLL had a trend toward higher prevalence of second LPD (4%) compared with previously untreated patients (2%; P = 0.053). More strikingly, patients treated with purine nucleoside analogues (PNA) had a significantly increased risk of subsequent second LPD (5.2%) compared with patients who had not received PNA (1.9%; P = 0.008). No statistically significant association was observed between risk of second LPD and other CLL characteristics (ZAP-70, CD38, IgVH mutation status or cytogenetic abnormalities). In this series, prior treatments with PNA or anthracyclines were the only significant factors associated with risk of developing a second LPD in patients with CLL. Physicians should strictly adhere to established criteria to initiate treatment for CLL patients who are not participating in clinical trials.

Original languageEnglish (US)
Pages (from-to)398-404
Number of pages7
JournalBritish journal of haematology
Issue number3
StatePublished - Nov 2007


  • Chronic lymphocytic leukaemia
  • Lymphoma
  • Prognostic parameters
  • Transformation
  • Treatment

ASJC Scopus subject areas

  • Hematology


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