Primary malignant tumors (lymphoma excluded) in patients with chronic lymphocytic leukemia. A series of 22 cases from a retrospective study of 248 patients.

This retrospective study was conducted to evaluate the incidence of primary malignant tumors in patients with chronic lymphocytic leukemia (CLL). Between 1974 and 1994, 313 patients were hospitalized for CLL. Patients lost to follow-up were excluded (n = 65). Among the remaining 248 patients (167 men and 81 women), 22 patients (8.8%) developed primary malignant tumors (17 males, 5 females; age range 48 to 90 years); those who developed Richter's lymphoma (n = 9) or basal cell epithelioma (n = 5) were excluded from the cohort of the cancer patient. There were 18 epithelial tumors (3 lung adenocarcinoma) and 4 parenchymal tumors. We observed only one cancer of the prostate, and no breast cancer. The malignant tumor occurred at the same time as CLL in 8 cases and after a delay of 3 to 11 years in the 14 other cases. There was no particular features in the stage of duration of CLL before diagnosis of cancer. Outcome was particularly unfavorable, 20 deaths, compared with mortality in the other 226 patients (53.5%). These findings, together with the data in the literature, emphasize the importance of careful follow-up in patients with CLL.