Retrospective investigation of secondary maligneses in patients with chronic lymphocytary leukemia

In our study, we aimed to detect the most common accompanying malignancies in chronic lymphocytic leukemia, to examine the epidemiological and laboratory characteristics of the patients followed in our clinic, and to screen for prognostic indicators. Materials and methods 107 CLL patients diagnosed and followed up between 01.01.2006 and 01.06.2022 by Ondokuz Mayıs University Faculty of Medicine Hematology Department were included in our study. Patient data were obtained from the hospital information management operation and patient files. Diagnostic data of the patients, age at diagnosis, follow-up period, hematological and biochemical profiles at the time of diagnosis, genotypic and bone marrow aspiration run results, flow cytometric part, imaging part were scanned. Patients are universed with systems recommended by national guidelines for use for chronic lymphocytic leukemia. The malignancies that gave the cells of the patients, their diagnosis history, epidemiological and laboratory features were screened. Treatments for CLL and cell-forming malignancies also include scanned values. Results In our study, the data of a total of 107 patients with CLL who were followed up and treated in Ondokuz Mayıs University Medical Faculty Hospital Hematology Department were analyzed. Of the patients, 63.55% (n=68) were male and 36.45% (n=39) were female. In our study, the male/female ratio was found to be 1.74. The mean age at diagnosis was 62.65±10.26 in males and 60.5±13.15 in females. Anemia was found in 23.3% (n=25) of the patients included in our study. The mean hemoglobin (hgb) value was 12.96±1.82 g/dl, the lowest hgb value was 9.20 g/dl, and the highest hbg value was 16.90 g/dl. 11.2% (n=12) of the patients included in our study had thrombocytopenia and the mean platelet values were calculated as 206.77±104.66 thousand/ul. The lowest platelet value was 10 thousand/ul while the highest platelet value was 811 thousand/ul. Is 19.63% (n=21) of the patients have a concomitant secondary malignancy. Looking at their frequency, the most common secondary cancers were lymphoma and lung cancer. A non-Hodgkin lymphoma was associated in 14.29% (n=3) of the patients with secondary cancer, and lung cancer in 14.29% (n=3) was accompanied by hodgkin lymphoma in 9.52% (n=2) While the mean age of diagnosis of patients without secondary cancer was 61.41±11.27, the mean age of diagnosis of patients with secondary cancer was 63.76±12.01. While 38.1% (n=8) of patients with secondary cancer had a cancer, the diagnosis of CLL was made later. While a diagnosis of CLL was present in 61.9% (n=13) of the patients, a second cancer occurred. While the time elapsed between the diagnosis of CLL and the diagnosis of secondary cancer was 57.8±87.1 months, the time between the diagnosis of CLL after the diagnosis of cancer was 49.4±31 months. In our study, 42.06% (n=45) of the patients we examined were diagnosed with CLL at stage 2 according to the RAI staging. The most commonly diagnosed stage was RAI stage-2. The ratio of patients diagnosed in RAI Stage 0 to the total number of patients was found to be 10.28% (n=10), and RAI stage 0 patients were found to be the smallest group in this regard in the study. The most commonly diagnosed stage is RAI stage-2, both in those without and with concomitant cancer. The patients were analyzed as early stage (RAI stage 0-2) and advanced stage (RAI stage 3,4). While 76.6% (n=82) of the patients were diagnosed at early stage, 24.4% (n=25) were diagnosed at late stage. Patients were diagnosed at early stage (RAI stage 0-2) and advanced stage (RAI stage 3). ,4) were analyzed as diseases with and without secondary malignancy. Secondary malignancy was detected in 20.73% (n=17) of the early stage patients and 16% (n=4) of the late stage patients. When the early stage and late stage patients were examined according to the secondary malignancy relationship with Fisher's chi-square test and Pearson-chi-square test, no statistically significant difference was found between the groups. ( p value 0.776) Of the patients with secondary malignancy, 61.9% were male (n=13) and 38.1% were female (n=8). The male/female ratio was found to be 1.62. When patients with secondary malignancies were compared with the Pearson chi-square test according to gender, no significant relationship was found between gender and secondary malignancy. (p=0.861) The patients were examined in terms of the treatment they received and their relationship with secondary malignancy. While 52.34% (n=56) of the patients were followed up after diagnosis, 47.66% (n=51) were found to have received treatment. It was observed that FCR regimen was given most frequently in first-line treatment. The FCR regimen was given to 26.17% (n=28) of the patients. FCR was the most commonly prescribed treatment regimen among those receiving first-line therapy in patients with secondary malignancies. Secondary malignancy was found in 38.89% (n=11) of patients receiving second-line therapy, while 50% of patients receiving third-line therapy (n=5) had secondary malignancies. ) secondary malignancy was detected. While 21.4% (n=12) of the patients who were followed up had secondary malignancy, 17.6% (n=9) of the patients who received treatment had a secondary malignancy. When the patients who were followed up and those who received treatment were evaluated with the Pearson chi-square test in terms of the development of secondary malignancy, no significant statistical data could be obtained. (p value 0.623) Discussion and Conclusion Different outcomes have been observed in the types of malignancies most frequently home to CLL, of origin from various parts of the world. In our study, the secondary malignancies that most frequently nested in CLL can be removed as lymphoma and cancer cancers. While skin cancers are the most common malignancies nesting in CLL in foreign countries, this may be related to the extent to which our study and studies conducted in foreign countries did not differ in this coverage. This expansion needs a volume with more patients