{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T11:09:45Z","timestamp":1780657785707,"version":"3.54.1"},"reference-count":31,"publisher":"Becaris Publishing Limited","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Comp. Eff. Res."],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:p>\n            <jats:bold>Aim:<\/jats:bold>\n            Improved management of chronic lymphocytic leukemia (CLL) has resulted in a growing population of CLL survivors; these patients have a higher risk of developing second primary malignancies (SPMs) versus the general population. This retrospective cohort study aims to assess the timing, frequency, incidence and types of SPMs in treated and untreated patients with CLL in the USA, using the Surveillance, Epidemiology, and End Results (SEER) Medicare database, which links a nationally representative cancer registry with Medicare claims data.\n            <jats:bold>Patients &amp; methods:<\/jats:bold>\n            Patients aged \u226566\u00a0years with newly diagnosed CLL between 1\u00a0January\u00a02010 and 31\u00a0December\u00a02016, who were enrolled in Parts A and B of Medicare for \u226512\u00a0months pre-diagnosis of CLL were selected from the database. Patients were assessed for \u226536\u00a0months until the end of continuous enrollment in Medicare Parts A, B and D, a switch to a health maintenance organization, death, or end of the study period (December\u00a02019).\n            <jats:bold>Results:<\/jats:bold>\n            Of 3053 patients included in the analyses, 620 (20.3%) were treated and 2433 (79.7%) were untreated within 36\u00a0months of diagnosis. Overall, 638 (20.9%) patients developed a SPM, 26.8% of patients in the treated cohort and 19.4% of patients in the untreated cohort. The most common SPMs for both cohorts were squamous cell carcinoma and acute myeloid leukemia. Among the 166 treated patients who developed a SPM, a greater proportion developed their first SPM after treatment initiation versus those who developed their first SPM prior to treatment initiation (p\u00a0&lt;\u00a00.001). A significantly lower percentage of patients who received targeted therapy developed a SPM (p\u00a0&lt;\u00a00.05) versus patients treated with anti-CD20\u00a0+ chemotherapy.\n            <jats:bold>Conclusion:<\/jats:bold>\n            Findings indicate that treatment type and timing can affect SPM development in patients with CLL. Combined with previous findings, this can help inform best practices in monitoring for SPM in patients with CLL.\n          <\/jats:p>","DOI":"10.57264\/cer-2023-0119","type":"journal-article","created":{"date-parts":[[2024,1,31]],"date-time":"2024-01-31T14:56:15Z","timestamp":1706712975000},"source":"Crossref","is-referenced-by-count":1,"title":["Assessment of second primary malignancies among treated and untreated patients with chronic lymphocytic leukemia using real-world data from the USA"],"prefix":"10.57264","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8377-8111","authenticated-orcid":false,"given":"Sikander","family":"Ailawadhi","sequence":"first","affiliation":[{"name":"Mayo Clinic, Jacksonville, FL\u00a032224, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arliene","family":"Ravelo","sequence":"additional","affiliation":[{"name":"Genentech, South San Francisco, CA\u00a094080, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen D","family":"Ng","sequence":"additional","affiliation":[{"name":"Genentech, South San Francisco, CA\u00a094080, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bonny","family":"Shah","sequence":"additional","affiliation":[{"name":"Genesis Research, Hoboken, NJ\u00a007030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil","family":"Lamarre","sequence":"additional","affiliation":[{"name":"Genesis Research, Hoboken, NJ\u00a007030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rongrong","family":"Wang","sequence":"additional","affiliation":[{"name":"Genentech, South San Francisco, CA\u00a094080, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Eakle","sequence":"additional","affiliation":[{"name":"Genentech, South San Francisco, CA\u00a094080, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliana ML","family":"Biondo","sequence":"additional","affiliation":[{"name":"Genentech, South San Francisco, CA\u00a094080, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"36897","reference":[{"issue":"3","key":"e_1_3_10_2_2","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1111\/bjh.16397","article-title":"Survival continues to increase in chronic lymphocytic leukaemia: a population-based analysis among 20,468 patients diagnosed in The Netherlands between 1989 and 2016","volume":"189","author":"van der Straten L","year":"2020","unstructured":"van der Straten L, Levin MD, Visser O Survival continues to increase in chronic lymphocytic leukaemia: a population-based analysis among 20,468 patients diagnosed in The Netherlands between 1989 and 2016. Br. J. Haematol. 189(3), 574\u2013577 (2020).","journal-title":"Br. J. Haematol."},{"issue":"9","key":"e_1_3_10_3_2","doi-asserted-by":"crossref","first-page":"1259","DOI":"10.3324\/haematol.2009.007849","article-title":"Improved survival in chronic lymphocytic leukemia in the past decade: a population-based study including 11,179 patients diagnosed between 1973\u20132003 in Sweden","volume":"94","author":"Sigurdur YK","year":"2009","unstructured":"Sigurdur YK, Paul WD, Wyndham HW, Neil C, Magnus B, Ola L. Improved survival in chronic lymphocytic leukemia in the past decade: a population-based study including 11,179 patients diagnosed between 1973\u20132003 in Sweden. Haematologica 94(9), 1259\u20131265 (2009).","journal-title":"Haematologica"},{"issue":"6","key":"e_1_3_10_4_2","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1097\/PPO.0000000000000416","article-title":"Targeted therapy in chronic lymphocytic leukemia","volume":"25","author":"Kipps TJ","year":"2019","unstructured":"Kipps TJ, Choi MY. Targeted therapy in chronic lymphocytic leukemia. Cancer J. 25(6), 378\u2013385 (2019).","journal-title":"Cancer J."},{"key":"e_1_3_10_5_2","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1186\/s13045-021-01054-w","article-title":"Current and future treatment strategies in chronic lymphocytic leukemia","volume":"14","author":"Patel K","year":"2021","unstructured":"Patel K, Pagel JM. Current and future treatment strategies in chronic lymphocytic leukemia. J. Hematol. Oncol. 14, 69 (2021).","journal-title":"J. Hematol. Oncol."},{"issue":"9","key":"e_1_3_10_6_2","doi-asserted-by":"crossref","first-page":"1432","DOI":"10.1002\/cncr.31931","article-title":"Chronic lymphocytic leukemia (CLL) treatment: so many choices, such great options","volume":"125","author":"Sharma S","year":"2019","unstructured":"Sharma S, Rai KR. Chronic lymphocytic leukemia (CLL) treatment: so many choices, such great options. Cancer 125(9), 1432\u20131440 (2019).","journal-title":"Cancer"},{"key":"e_1_3_10_7_2","doi-asserted-by":"crossref","first-page":"3581","DOI":"10.1182\/blood-2018-99-120123","article-title":"Risk of second primary malignancies in chronic lymphocytic leukemia","volume":"132","author":"Kommalapati A","year":"2018","unstructured":"Kommalapati A, Tella SH, Goyal G. Risk of second primary malignancies in chronic lymphocytic leukemia. Blood 132, 3581 (2018).","journal-title":"Blood"},{"issue":"7","key":"e_1_3_10_8_2","doi-asserted-by":"crossref","first-page":"1076","DOI":"10.1038\/bjc.2011.313","article-title":"Second cancer incidence and cancer mortality among chronic lymphocytic leukaemia patients: a population-based study","volume":"105","author":"Royle JA","year":"2011","unstructured":"Royle JA, Baade PD, Joske D, Girschik J, Fritschi L. Second cancer incidence and cancer mortality among chronic lymphocytic leukaemia patients: a population-based study. Br. J. Cancer 105(7), 1076\u20131081 (2011).","journal-title":"Br. J. Cancer"},{"issue":"2","key":"e_1_3_10_9_2","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1111\/bjh.17337","article-title":"Risk of new malignancies among patients with CLL treated with chemotherapy: results of a Danish population-based study","volume":"193","author":"da Cunha-Bang C","year":"2021","unstructured":"da Cunha-Bang C, Rostgaard K, Andersen MA Risk of new malignancies among patients with CLL treated with chemotherapy: results of a Danish population-based study. Br. J. Haematol. 193(2), 339\u2013345 (2021).","journal-title":"Br. J. Haematol."},{"issue":"10","key":"e_1_3_10_10_2","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1038\/s41408-019-0237-1","article-title":"Trends in the risk of second primary malignancies among survivors of chronic lymphocytic leukemia","volume":"30","author":"Kumar V","year":"2019","unstructured":"Kumar V, Ailawadhi S, Bojanini L Trends in the risk of second primary malignancies among survivors of chronic lymphocytic leukemia. Blood Cancer J. 30(10), 75 (2019).","journal-title":"Blood Cancer J."},{"issue":"6","key":"e_1_3_10_11_2","doi-asserted-by":"crossref","first-page":"1643","DOI":"10.3109\/10428194.2014.957203","article-title":"Second cancers in patients with chronic lymphocytic leukemia who received frontline fludarabine, cyclophosphamide and rituximab therapy: distribution and clinical outcomes","volume":"56","author":"Benjamini O","year":"2015","unstructured":"Benjamini O, Jain P, Trinh L Second cancers in patients with chronic lymphocytic leukemia who received frontline fludarabine, cyclophosphamide and rituximab therapy: distribution and clinical outcomes. Leuk. Lymphoma 56(6), 1643\u20131650 (2015).","journal-title":"Leuk. 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Leukemia 34(12), 3197\u20133205 (2020).","journal-title":"Leukemia"},{"key":"e_1_3_10_14_2","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1182\/blood-2020-140042","article-title":"Risk of secondary malignancy in CLL patients treated with novel targeted agents","volume":"136","author":"Eversman A","year":"2020","unstructured":"Eversman A, Cao S, Boughan KM Risk of secondary malignancy in CLL patients treated with novel targeted agents. Blood 136, 46\u201347 (2020).","journal-title":"Blood"},{"key":"e_1_3_10_15_2","unstructured":"West LA Samantha C Goodkins D He W. 65+ in the United States: 2010 Special Studies: Current Population Reports. Table 2\u201310. https:\/\/www.census.gov\/content\/dam\/Census\/library\/publications\/2014\/demo\/p23-212.pdf (2023)."},{"issue":"10","key":"e_1_3_10_16_2","doi-asserted-by":"crossref","first-page":"1016","DOI":"10.1093\/aje\/kwi307","article-title":"Survival bias associated with time-to-treatment initiation in drug effectiveness evaluation: a comparison of methods","volume":"162","author":"Zhou Z","year":"2005","unstructured":"Zhou Z, Rahme E, Abrahamowicz M, Pilote L. Survival bias associated with time-to-treatment initiation in drug effectiveness evaluation: a comparison of methods. Am. J. Epidemiol. 162(10), 1016\u20131023 (2005).","journal-title":"Am. J. Epidemiol."},{"issue":"6","key":"e_1_3_10_17_2","doi-asserted-by":"crossref","first-page":"1322","DOI":"10.1097\/CCM.0b013e3182120829","article-title":"Utilization patterns and patient outcomes associated with use of rescue therapies in acute lung injury","volume":"39","author":"Walkey AJ","year":"2011","unstructured":"Walkey AJ, Wiener RS. Utilization patterns and patient outcomes associated with use of rescue therapies in acute lung injury. Crit. Care Med. 39(6), 1322\u20131328 (2011).","journal-title":"Crit. Care Med."},{"issue":"6","key":"e_1_3_10_18_2","doi-asserted-by":"crossref","first-page":"e009518","DOI":"10.1136\/bmjopen-2015-009518","article-title":"Prediction of individual combined benefit and harm for patients with atrial fibrillation considering warfarin therapy: a study protocol","volume":"5","author":"Li G","year":"2015","unstructured":"Li G, Holbrook A, Delate T, Witt DM, Levine MA, Thabane L. 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Ther."},{"issue":"4","key":"e_1_3_10_20_2","first-page":"100487","article-title":"Economic burden of recurrence among resected medicare patients with early stage NSCLC","volume":"4","author":"Lee JM","year":"2023","unstructured":"Lee JM, Wang R, Johnson A, Ogale S, Kent M, Lee JS. Economic burden of recurrence among resected medicare patients with early stage NSCLC. JTO Clin. Res. Rep. 4(4), 100487 (2023).","journal-title":"JTO Clin. Res. Rep."},{"issue":"2","key":"e_1_3_10_21_2","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1182\/blood.2021010845","article-title":"The CLL12 trial: ibrutinib vs placebo in treatment-na\u00efve, early-stage chronic lymphocytic leukemia","volume":"139","author":"Langerbeins P","year":"2022","unstructured":"Langerbeins P, Zhang C, Robrecht S The CLL12 trial: ibrutinib vs placebo in treatment-na\u00efve, early-stage chronic lymphocytic leukemia. 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Leukemia 36(4), 1171\u20131175 (2022).","journal-title":"Leukemia"},{"issue":"1","key":"e_1_3_10_24_2","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1186\/s13046-021-02115-1","article-title":"Restoration of the immune function as a complementary strategy to treat chronic lymphocytic leukemia effectively","volume":"40","author":"Moreno C","year":"2021","unstructured":"Moreno C, Mu\u00f1oz C, Terol MJ, Hern\u00e1ndez-Rivas J\u00c1, Villanueva M. Restoration of the immune function as a complementary strategy to treat chronic lymphocytic leukemia effectively. J. Exp. Clin. Cancer. Res. 40(1), 321 (2021).","journal-title":"J. Exp. Clin. Cancer. Res."},{"key":"e_1_3_10_25_2","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1038\/s41408-023-00784-z","article-title":"Risk of second primary malignancies in patients with chronic lymphocytic leukemia: a population-based study in The Netherlands 1989\u20132019","volume":"13","author":"van der Straten L","year":"2023","unstructured":"van der Straten L, Levin MD, Dinnessen MAW Risk of second primary malignancies in patients with chronic lymphocytic leukemia: a population-based study in The Netherlands 1989\u20132019. Blood Cancer J. 13, 15 (2023).","journal-title":"Blood Cancer J."},{"key":"e_1_3_10_26_2","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1002\/jha2.366","article-title":"Second primary malignancies in chronic lymphocytic leukaemia: skin, solid organ, haematological and Richter's syndrome","volume":"3","author":"Shen Y","year":"2022","unstructured":"Shen Y, Coyle L, Kerridge I Second primary malignancies in chronic lymphocytic leukaemia: skin, solid organ, haematological and Richter's syndrome. eJHaem. 3, 129\u2013138 (2022).","journal-title":"eJHaem."},{"issue":"3","key":"e_1_3_10_27_2","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1080\/17474086.2022.2042246","article-title":"Secondary primary malignancies after treatment with chemo-immunotherapy in treatment-na\u00efve patients with CLL: a systematic literature review","volume":"15","author":"Csan\u00e1di M","year":"2022","unstructured":"Csan\u00e1di M, \u00c1gh T, Tordai A, Tapprich C, Vok\u00f3 Z, Stamatopoulos K. Secondary primary malignancies after treatment with chemo-immunotherapy in treatment-na\u00efve patients with CLL: a systematic literature review. Expert. Rev. Hematol. 15(3), 273\u2013284 (2022).","journal-title":"Expert. Rev. Hematol."},{"issue":"3","key":"e_1_3_10_28_2","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1182\/blood-2009-07-235358","article-title":"Diagnosis and management of acute myeloid leukemia in adults: recommendations from an international expert panel, on behalf of the European LeukemiaNet","volume":"115","author":"D\u00f6hner H","year":"2010","unstructured":"D\u00f6hner H, Estey EH, Amadori S Diagnosis and management of acute myeloid leukemia in adults: recommendations from an international expert panel, on behalf of the European LeukemiaNet. Blood 115(3), 453\u2013474 (2010).","journal-title":"Blood"},{"key":"e_1_3_10_29_2","unstructured":"National Cancer Institute. Surveillance Epidemiology and End Results Program. https:\/\/seer.cancer.gov\/about\/using-website.html (2023)."},{"key":"e_1_3_10_30_2","unstructured":"National Cancer Institute. Surveillance Epidemiology and End Results Program Overview. https:\/\/seer.cancer.gov\/about\/factsheets\/SEER_Overview.pdf (2023)."},{"issue":"1","key":"e_1_3_10_31_2","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1111\/cts.12683","article-title":"The advantages and challenges of using real-world data for patient care","volume":"13","author":"Ho YF","year":"2020","unstructured":"Ho YF, Hu FC, Lee PI. The advantages and challenges of using real-world data for patient care. Clin. Transl. Sci. 13(1), 4\u20137 (2020).","journal-title":"Clin. Transl. Sci."},{"issue":"11","key":"e_1_3_10_32_2","doi-asserted-by":"crossref","first-page":"1763","DOI":"10.1007\/s12325-018-0805-y","article-title":"Interpretation and impact of real-world clinical data for the practicing clinician","volume":"35","author":"Blonde L","year":"2018","unstructured":"Blonde L, Khunti K, Harris SB, Meizinger C, Skolnik NS. Interpretation and impact of real-world clinical data for the practicing clinician. Adv. Ther. 35(11), 1763\u20131774 (2018).","journal-title":"Adv. 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