{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T11:10:30Z","timestamp":1780657830334,"version":"3.54.1"},"reference-count":29,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,6,13]],"date-time":"2023-06-13T00:00:00Z","timestamp":1686614400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hematological Oncology"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    With improvement in survival after chronic lymphocytic leukemia (CLL) diagnosis, the real\u2010world burden of second hematological malignancies (SHM) has not been comprehensively assessed in recent era. We analyzed risk, incidence, and outcomes of SHM in CLL patients between 2000 and 2019 using SEER database. CLL patients had greater risk for hematological malignancies than general population [SIR, standardized incidence ratio (95% CI):2.58 (2.46\u20132.70);\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0&lt;\u00a00.05]. The risk for subsequent lymphoma increased by 1.75 folds in 2015\u20132019 compared to 2000\u20132004. The duration, after CLL diagnosis, of maximum risk for SHM decreased as 60\u2013119\u00a0months for time\u2010period 2000\u20132004, 6\u201311\u00a0months for 2005\u20132009 to 2\u20135\u00a0months for 2010\u20132014 and 2015\u20132019. Incidence of SHM was 2.5% in CLL survivors (1736\/70,346) with lymphoid SHM being more common than myeloid SHM, and DLBCL being the most common pathology (\n                    <jats:italic>n<\/jats:italic>\n                    \u00a0=\u00a0610, 35% of all SHM). Male sex, age \u226465\u00a0years at CLL diagnosis, and chemotherapy treatment were associated with higher risk for SHM. The median gap between CLL and SHM diagnoses was 46\u00a0months. The median survival for de\u2010novo\u2010AML, t\u2010MN, CML, and aggressive NHL was 63, 86, 95, and 96\u00a0months respectively. Although SHM remains rare, there is increased risk in recent era, likely due to improved survival in CLL patients, necessitating active surveillance strategies.\n                  <\/jats:p>","DOI":"10.1002\/hon.3192","type":"journal-article","created":{"date-parts":[[2023,6,13]],"date-time":"2023-06-13T03:06:11Z","timestamp":1686625571000},"page":"884-893","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A population level analysis of second hematological malignancies in chronic lymphocytic leukemia\/small lymphocytic lymphoma survivors in the era of targeted therapies"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5631-1164","authenticated-orcid":false,"given":"Rahul","family":"Mishra","sequence":"first","affiliation":[{"name":"Department of Hematology and Oncology Cleveland Clinic Taussig Cancer Institute  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danai","family":"Dima","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology Cleveland Clinic Taussig Cancer Institute  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9689-9978","authenticated-orcid":false,"given":"Sumukh A.","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Saint Vincent Hospital  Worcester Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agrima","family":"Mian","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Cleveland Clinic Foundation  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alankrita","family":"Taneja","sequence":"additional","affiliation":[{"name":"Department of Medicine Roswell Park Comprehensive Cancer Center  Buffalo New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahul","family":"Karna","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Allegheny General Hospital  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo F.","family":"Caimi","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology Cleveland Clinic Taussig Cancer Institute  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian T.","family":"Hill","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology Cleveland Clinic Taussig Cancer Institute  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Dean","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology Cleveland Clinic Taussig Cancer Institute  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepa","family":"Jagadeesh","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology Cleveland Clinic Taussig Cancer Institute  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,6,13]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"Key statistics for chronic lymphocytic leukemia. Accessed December 30 2022.https:\/\/www.cancer.org\/cancer\/chronic-lymphocytic-leukemia\/about\/key-statistics.html"},{"key":"e_1_2_11_3_1","volume-title":"SEER Lifetime Risk (Percent) of Being Diagnosed with Cancer by Site and Race\/Ethnicity: Both Sexes, 18 SEER Areas, 2012\u20102014 (Table 1.15)"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-021-04600-1"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41571-018-0037-8"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2016.113"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2002.08.128"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2007.06801.x"},{"issue":"2","key":"e_1_2_11_9_1","first-page":"337","article-title":"Subsequent cancer in patients with chronic lymphocytic leukemia\u2010\u2010a possible immunologic mechanism","volume":"61","author":"Greene MH","year":"1978","journal-title":"J Natl Cancer Inst"},{"issue":"4","key":"e_1_2_11_10_1","first-page":"285","article-title":"Generalized reticular cell sarcoma of lymph nodes associated with lymphatic leukemia","volume":"4","author":"Richter MN","year":"1928","journal-title":"Am J Pathol"},{"key":"e_1_2_11_11_1","first-page":"621","article-title":"Chronic lymphoid leukemia secondarily associated with a malignant reticulopathy: richter\u2019s syndrome","volume":"4","author":"Lortholary P","year":"1964","journal-title":"Nouv Rev Fr Hematol"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/ejh.13396"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/jha2.366"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41408-023-00784-z"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.3109\/10428194.2014.957203"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1080\/10428190310001612939"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.17337"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-020-0987-6"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2020-140042"},{"key":"e_1_2_11_20_1","unstructured":"About the SEER Program.Seer. 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