Does Hypergammaglobulinemia Predispose to Secondary Malignancies?

[Guest guest]

[5343] Does Hypergammaglobulinemia Predispose to Secondary Solid

Tumors in Patients with Chronic Lymphocytic Leukemia? Session Type:

Publication Only

Vijay Patel, Jaswinder Singh, Ashok Malani, Barry Skikne, Chao Haung,

Vanveldhuizen, Suman Kambhampati Hematology/Oncology, VA

Medical Center, Kansas City, MO, USA; Hematology/Oncology, Kansas

University Medical Center, Kansas City, KS, USA

Background: Occurrence of second hematological malignancies in

patients with chronic lymphocytic leukemia (CLL) is well known but

development of secondary solid tumors has not been well documented.

Isolated case reports indicate that CLL patients may have a

predisposition to develop solid tumors. There is not enough

literature available to support this hypothesis. We here intend to

study the incidence of secondary solid tumors in CLL patients with

regard to their treatment and immunoglobulin levels.

Methods: We reviewed the medical records of 323 CLL patients over the

last 20 years at Veteran Affairs Medical Center, Kansas City.

Broadly, the patients were divided into two groups; the group who

received chemotherapy for CLL(74/323) versus the group who did not

receive treatment (249/323) and their median immunoglobulin levels

were also documented. Patients who developed secondary hematological

malignancies were excluded from this study.

Results: The overall incidence of solid tumors was found to be 14.8%

(48/323). In the chemotherapy treated CLL, the incidence of solid

tumors was 18%(14/74) as compared to 13.6% (34/249) in the non-

therapeutic group(P value 0.12). The most common malignancies noted

were gastro-intestinal malignancies, genitor-urinary tumors and skin

cancers including melanomas. Interestingly, CLL patients who

developed secondary solid tumors had a higher median IgG levels (1010

g/L) when compared to those who did not develop secondary tumors (738

g/L, P value <0.003)

Conclusion: Our study shows that there is a higher overall incidence

of secondary solid tumors in patients with CLL when compared with

incidence in the general population. There is no significant increase

in the incidence of therapy related solid tumors in CLL patients.

Upward drift in immunoglobulin levels should raise a suspicion for

diagnosis of secondary solid tumors in patients with CLL. More

studies are warranted to confirm this finding.