1. Myeloid neoplasms in the setting of chronic lymphocytic leukaemia/chronic lymphocytic leukaemia-like disease: a clinicopathological study of 66 cases comparing cases with prior history of treatment to those without
- Author
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Catherine Luedke, Jerald Z. Gong, Lian-He Yang, Yue Zhao, Rachel Jug, Jenna McCracken, Jonathan Galeotti, Jake Maule, Imran Siddiqi, Endi Wang, and Chuanyi M. Lu
- Subjects
medicine.medical_specialty ,Myeloid ,Disease ,Gastroenterology ,Pathology and Forensic Medicine ,Myeloid Neoplasm ,Pathogenesis ,03 medical and health sciences ,0302 clinical medicine ,Myeloproliferative Disorders ,immune system diseases ,hemic and lymphatic diseases ,Internal medicine ,Humans ,Medicine ,Retrospective Studies ,business.industry ,Myelodysplastic syndromes ,General Medicine ,medicine.disease ,Leukemia, Lymphocytic, Chronic, B-Cell ,Fludarabine ,Leukemia ,medicine.anatomical_structure ,Leukemia, Myeloid ,Myelodysplastic Syndromes ,030220 oncology & carcinogenesis ,business ,030215 immunology ,medicine.drug - Abstract
AimsMyeloid neoplasms occur in the setting of chronic lymphocytic leukaemia (CLL)/CLL-like disease. The underlying pathogenesis has not been elucidated.MethodsRetrospectively analysed 66 cases of myeloid neoplasms in patients with CLL/CLL-like disease.ResultsOf these, 33 patients (group 1) had received treatment for CLL/CLL-like disease, while the other 33 patients (group 2) had either concurrent diagnoses or untreated CLL/CLL-like disease before identifying myeloid neoplasms. The two categories had distinct features in clinical presentation, spectrum of myeloid neoplasm, morphology, cytogenetic profile and clinical outcome. Compared with group 2, group 1 demonstrated a younger age at the diagnosis of myeloid neoplasm (median, 65 vs 71 years), a higher fraction of myelodysplastic syndrome (64% vs 36%; OR: 3.1; pConclusionsMyeloid neoplasm in the setting of CLL/CLL-like disease can be divided into two categories, one with prior treatment for CLL/CLL-like disease and the other without. CLL-type treatment may accelerate myeloid leukaemogenesis. The risk is estimated to be 13-fold higher in patients with treatment than those without. The causative agent could be attributed to fludarabine in combination with alkylators, based on the latency of myeloid leukaemogenesis and the cytogenetic profile.
- Published
- 2021
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