The clinical course of lung carcinoma in patients with chronic lymphocytic leukemia

K Parekh, V Rusch, M Kris
Cancer 1999 November 1, 86 (9): 1720-3

BACKGROUND: Although patients with chronic lymphocytic leukemia (CLL) have an increased risk of developing second primary malignancies, including lung carcinoma, there is virtually no information about their clinical outcomes. To evaluate this, the authors reviewed their 20-year institutional experience with CLL patients who also had lung carcinoma.

METHODS: The records of patients with diagnoses of both CLL and lung carcinoma seen between January 1977 and July 1998 were reviewed. The data collected included patient demographics, the tumor histology and stage, the type of treatment for both CLL and lung carcinoma, the presence of a third malignancy, the disease status at last follow-up, and the first site of relapse. Survival was calculated by the Kaplan-Meier method.

RESULTS: From January 1977 to July 1998, 1329 patients with CLL were seen at Memorial Sloan-Kettering Cancer Center. Twenty-six (1.9%) also had lung carcinoma (19 males and 7 females). The median age of patients at the time CLL was diagnosed was 61 years, and for patients with lung carcinoma it was 68 years. Twenty-two patients (85%) were current or former smokers. Histologically, the lung carcinomas included 6 squamous cell carcinomas, 19 nonsquamous carcinomas, and 1 small cell carcinoma. Ten patients (38%) had a third malignancy; these malignancies included melanoma, basal cell carcinoma, laryngeal carcinoma, and colon carcinoma. Thirteen patients underwent surgical resection and 13 were treated nonsurgically for lung carcinoma. A poor performance status precluded surgery for 3 patients with Stage I tumors and limited chemotherapy for all patients with advanced disease. The median survival following the diagnosis of lung carcinoma for patients treated surgically was 25 months, and for those treated nonsurgically it was 6 months.

CONCLUSIONS: Approximately 2% of patients with CLL develop lung carcinoma. In this study, 85% of the patients were smokers. These patients had a high risk of a third primary malignancy. Lung carcinoma was diagnosed a decade after CLL. Patients who develop both diseases die of lung carcinoma and not CLL or other solid tumors. CLL and poor performance status limit treatment, particularly for patients with unresectable lung carcinoma.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Trending Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"