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We analyzed 25,814 newly diagnosed CLL patients from Czechia, Hungary, and Poland; 10,312 (39.9%) patients were treated for CLL in study periods between 2004 and 2016. Out of the treated patients, 1986 (19.3%) received the FCR therapy in the first line and 779 (7.6%) received FCR in subsequent lines. We observed that 33.7% of treated patients developed secondary malignancies during the study. Based on country estimates, the probability to develop a secondary malignancy within 4\u2009years since starting the first\u2010line FCR therapy ranged between 28.0% and 36.8%. We found the age at diagnosis, male gender, any malignancy prior to the CLL diagnosis, and the CLL treatment to be the key risk factors for developing secondary malignancies. Specifically, the FCR therapy was a statistically significant (<jats:italic>p<\/jats:italic>\u00a0&lt;\u20090.001) prognostic factor for risk increase with the hazard ratio between 1.46 and 1.60. Across the three Central European countries, we observed consistent results indicating FCR increased the risk of secondary malignancies in CLL patients. We conclude that secondary malignancies are clearly an undervalued burden for CLL patients, caregivers, and the healthcare system. When evaluating new therapies in regulatory and reimbursement decision making, the factor of secondary malignancies deserves deeper considerations.<\/jats:p>","DOI":"10.1002\/cam4.5033","type":"journal-article","created":{"date-parts":[[2022,10,7]],"date-time":"2022-10-07T09:29:23Z","timestamp":1665134963000},"page":"1961-1971","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Secondary malignancies and survival of <scp>FCR\u2010treated<\/scp> patients with chronic lymphocytic leukemia in Central Europe"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6770-9071","authenticated-orcid":false,"given":"Fruzsina","family":"K\u00f3sa","sequence":"first","affiliation":[{"name":"Janssen Global Services LLC  Budapest Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tereza","family":"Ne\u010dasov\u00e1","sequence":"additional","affiliation":[{"name":"Institute of Biostatics and Analysis Ltd.  Brno Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"\u0160pa\u010dek","sequence":"additional","affiliation":[{"name":"General University Hospital in Prague  Prague Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krzysztof","family":"Giannopoulos","sequence":"additional","affiliation":[{"name":"Experimental Hematooncology Department Medical University of Lublin  Lublin Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iwona","family":"Hus","sequence":"additional","affiliation":[{"name":"Medical University of Lublin, Department of Clinical Transplantology Medical University of Lublin  Lublin Poland"},{"name":"Instutute of Hematology and Transfusion Medicine  Warsaw Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tereza","family":"Jurkov\u00e1","sequence":"additional","affiliation":[{"name":"Institute of Biostatics and Analysis Ltd.  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