Department of Dermatology, Mayo Clinic, Rochester, MN, USA.
Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA.
Int J Dermatol. 2017 Nov;56(11):1125-1129. doi: 10.1111/ijd.13653. Epub 2017 Jul 7.
Second hematologic cancers in patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL) are well documented and include Hodgkin lymphoma, therapy-related acute myeloid leukemia/myelodysplastic syndromes, and transformation to diffuse large B-cell lymphoma. Although cutaneous T-cell lymphoma (CTCL) has been reported in patients with CLL, the incidence and comparison to expected rates are unknown. We evaluated the incidence of CTCL among patients with CLL or other non-Hodgkin lymphoma (NHL) subtypes using data from the Surveillance, Epidemiology, and End Results (SEER) Program.
We searched the SEER 13 registries for patients with a diagnosis of CLL and NHL between 1992 and 2008. Among patients identified, we evaluated the incidence of CTCL.
Among 31,286 patients with CLL, the incidence of CTCL was not significantly higher in men than women: 104.2 (95% CI, 50.0-191.8) and 28.1 (95% CI, 3.4-101.3) per 1,000,000 person-years, respectively (P = 0.06). Among 97,691 patients with NHL, the incidence of CTCL was similar in men and women (97.9 [95% CI, 62.0-146.9] and 92.0 [95% CI, 56.2-142.1] per 1,000,000 person-years, respectively; P = 0.84). The incidence of CTCL among males with CLL (standardized incidence ratio [SIR], 3.0 [95% CI, 1.4-5.5]), males with NHL (SIR, 3.7 [95% CI, 2.3-5.5]), and females with NHL (SIR, 5.9 [95% CI, 3.6-9.1]) was significantly higher than expected in the general population (all P < 0.001).
The risk of CTCL is greater in men with CLL than in the general population. In patients with NHL, both men and women are at greater risk for CTCL than in the general population.
慢性淋巴细胞白血病/小淋巴细胞淋巴瘤(CLL)患者的第二血液系统癌症已有充分记录,包括霍奇金淋巴瘤、治疗相关的急性髓系白血病/骨髓增生异常综合征以及转化为弥漫性大 B 细胞淋巴瘤。尽管已经有报道称 CLL 患者中存在皮肤 T 细胞淋巴瘤(CTCL),但其发病率和与预期比率的比较尚不清楚。我们使用监测、流行病学和最终结果(SEER)计划的数据评估了 CLL 或其他非霍奇金淋巴瘤(NHL)亚型患者中 CTCL 的发病率。
我们在 1992 年至 2008 年间在 SEER 13 个登记处搜索了 CLL 和 NHL 诊断患者。在确定的患者中,我们评估了 CTCL 的发病率。
在 31286 例 CLL 患者中,男性 CTCL 的发病率明显高于女性:每 100 万人年分别为 104.2(95%CI,50.0-191.8)和 28.1(95%CI,3.4-101.3)(P=0.06)。在 97691 例 NHL 患者中,男性和女性 CTCL 的发病率相似(男性分别为 97.9(95%CI,62.0-146.9)和 92.0(95%CI,56.2-142.1)每 100 万人年;P=0.84)。CLL 男性(标准化发病比 [SIR],3.0 [95%CI,1.4-5.5])、NHL 男性(SIR,3.7 [95%CI,2.3-5.5])和 NHL 女性(SIR,5.9 [95%CI,3.6-9.1])患者的 CTCL 发病率明显高于普通人群(均 P<0.001)。
CLL 男性的 CTCL 风险高于普通人群。在 NHL 患者中,男性和女性患 CTCL 的风险均高于普通人群。