Hisada M, Biggar R J, Greene M H, Fraumeni J F, Travis L B
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20852, USA.
Blood. 2001 Sep 15;98(6):1979-81. doi: 10.1182/blood.v98.6.1979.
Prior reports indicate that patients with chronic lymphocytic leukemia (CLL) may be at increased risk of subsequent neoplasms. This study quantified the risk of second cancers among 16 367 patients with CLL in the population-based Surveillance, Epidemiology and End Results Program. Overall, the observed/expected ratio (O/E) was 1.20 (95% confidence interval [CI], 1.15-1.26). Second cancer risks for patients who received chemotherapy only as the first course of treatment (O/E = 1.21) were similar to risks for those who received no treatment initially (O/E = 1.19). Significant excesses were found for Kaposi sarcoma (O/E = 5.09), malignant melanoma (O/E = 3.18), and cancers of the larynx (O/E = 1.72) and the lung (O/E = 1.66). Increased risks were also found for brain cancer among men (O/E =1.91) and for cancers of the stomach (O/E = 1.76) and bladder (O/E = 1.52) among women. Additional investigations of cancers after CLL are needed to explore the role of immunologic impairment and/or other etiologic influences.
先前的报告表明，慢性淋巴细胞白血病（CLL）患者后续发生肿瘤的风险可能会增加。本研究在基于人群的监测、流行病学和最终结果计划中，对16367例CLL患者发生第二种癌症的风险进行了量化。总体而言，观察到的/预期的比率（O/E）为1.20（95%置信区间[CI]，1.15 - 1.26）。仅接受化疗作为首个疗程的患者发生第二种癌症的风险（O/E = 1.21）与最初未接受治疗的患者风险（O/E = 1.19）相似。发现卡波西肉瘤（O/E = 5.09）、恶性黑色素瘤（O/E = 3.18）以及喉癌（O/E = 1.72）和肺癌（O/E = 1.66）有显著的超额发生率。男性患脑癌的风险增加（O/E = 1.91），女性患胃癌（O/E = 1.76）和膀胱癌（O/E = 1.52）的风险增加。需要对CLL后的癌症进行进一步调查，以探讨免疫功能损害和/或其他病因影响的作用。
