Document Detail

Second malignancies and Richter's syndrome in patients with chronic lymphocytic leukemia.
MedLine Citation:
PMID:  15763979     Owner:  NLM     Status:  MEDLINE    
Second malignancies are frequent complications in patients with chronic lymphocytic leukemia (CLL). Patients with this leukemia may develop large cell lymphoma (LCL) known as Richter's syndrome (RS). RS occurs in CLL patients of about 3% and may develop in a single lymph node or more often in a group of nodes. However, in some patients extranodal localization of aggressive lymphoma in RS has been observed. Besides LCL, Hodgkin's disease, prolymphocytoid leukemia, multiple myeloma and acute lymphoblastic leukemia may also occur as RS variants. The origin of lymphoid cells in RS remains tentative. However, CLL and RS originate from the same clone for some patients, whereas, in other patients cells of aggressive lymphoma do not have the features of the same clone as the CLL cells. The prognosis of RS is poor. Survival in different studies will be usually 2-5 months. The secondary development or coexistence of myeloproliferative disorders or myelodysplastic syndrome and solid tumors have also been rarely documented in CLL patients. It is of great concern that therapy may further increase the risk of a second neoplasm. However, until now, there are no clear evidence that alkylating agents or purine nucleoside analogs may be associated with an increased incidence of second malignancies in patients with CLL. In this review, epidemiology, biology, clinical characteristic and treatment approaches in RS and other secondary neoplasms in patients with CLL are discussed.
Tadeusz Robak
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Hematology (Amsterdam, Netherlands)     Volume:  9     ISSN:  1024-5332     ISO Abbreviation:  Hematology     Publication Date:    2004 Oct-Dec
Date Detail:
Created Date:  2005-03-14     Completed Date:  2005-04-28     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9708388     Medline TA:  Hematology     Country:  England    
Other Details:
Languages:  eng     Pagination:  387-400     Citation Subset:  IM    
Department of Hematology, Medical University of Lodz and Copernicus Memorial Hospital, Lodz, Pabianicka, Poland.
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MeSH Terms
Cell Lineage
Disease-Free Survival
Leukemia, Lymphocytic, Chronic, B-Cell / complications*,  mortality,  therapy
Lymphoma, Large B-Cell, Diffuse / etiology*,  mortality,  therapy
Neoplasms, Second Primary / etiology*,  mortality,  therapy

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