Chronic lymphoproliferative disorders and secondary cancers in the era of purine analogues and beyond

Leuk Lymphoma. 2021 Apr;62(4):771-778. doi: 10.1080/10428194.2020.1849682. Epub 2020 Nov 22.

Abstract

The low grade chronic lymphoproliferative disorders include chronic lymphocytic leukemia, Waldenstroms macroglobulinemia, follicular lymphoma and hairy cell leukemia. Traditionally considered incurable, these disorders have been associated with a risk of haematological and solid organ malignancies secondary to both the underlying disease and the associated treatment. The introduction of purine analogues into treatment paradigms has seen increased rates of therapy related myelodysplasia reported and it remains unclear yet on the impact the targeted novel therapies play in the development of secondary cancers. We review the rates of secondary malignancy in the chronic lymphoproliferative disorders with a particular focus on the role of the purine analogues in the development of therapy related MDS.

Keywords: CLL;; fludarabine;; myelodysplastic syndrome.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents* / therapeutic use
  • Humans
  • Leukemia, Lymphocytic, Chronic, B-Cell* / complications
  • Leukemia, Lymphocytic, Chronic, B-Cell* / drug therapy
  • Leukemia, Lymphocytic, Chronic, B-Cell* / epidemiology
  • Lymphoproliferative Disorders* / drug therapy
  • Lymphoproliferative Disorders* / epidemiology
  • Lymphoproliferative Disorders* / etiology
  • Myelodysplastic Syndromes* / epidemiology
  • Neoplasms, Second Primary* / epidemiology
  • Neoplasms, Second Primary* / etiology
  • Purines / adverse effects

Substances

  • Antineoplastic Agents
  • Purines