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Clonal Evolution and Second Malignancies in B-CLL

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Chronic Lymphocytic Leukemia

Part of the book series: Contemporary Hematology ((CH))

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Abstract

Chronic lymphocytic leukemia (CLL) is a malignancy of B-lymphocytes characterized by accumulation of neoplastic cells with low proliferative capacity but a disrupted apoptotic pathway that hampers programmed cell death, resulting in their prolonged life span (1,2). As a consequence, many patients afflicted by CLL follow an indolent or slowly progressive course often, requiring no treatment (3). Because of this slow course and because CLL primarily affects the elderly [mean age at diagnosis, 60–65 (4)] most patients die with rather than of the disease or its complications. Indeed, many CLL patients with early-stage disease [Rai low risk (5) or Binet stage A (6)] have a normal life span (7). However, in a substantial number of patients, survival is shortened by the multifaceted pathological impact of progressive disease (8,9) or its treatment (10) and (to a much lesser extent) by clonal evolution to a more aggressive disease (11) or the development of second malignancies (12–16). This chapter examines the most recent literature on CLL clonal evolution, especially Richter’s syndrome, and reviews Surveillance, Epidemiology, and End Results (SEER) data in order to quantify the risk for and types of second malignancies suffered by patients with CLL.

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  1. Guy B. Faguet MD
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  1. Section of Hematology/Oncology, Veterans Affairs Medical Center, Augusta, GA, USA

    Guy B. Faguet MD

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Faguet, G.B. (2004). Clonal Evolution and Second Malignancies in B-CLL. In: Faguet, G.B. (eds) Chronic Lymphocytic Leukemia. Contemporary Hematology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-412-2_21

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  • DOI: https://doi.org/10.1007/978-1-59259-412-2_21

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-61737-355-8

  • Online ISBN: 978-1-59259-412-2

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