Logo image
Delineation of clinical and biological factors associated with cutaneous squamous cell carcinoma among patients with chronic lymphocytic leukemia
Journal article   Open access   Peer reviewed

Delineation of clinical and biological factors associated with cutaneous squamous cell carcinoma among patients with chronic lymphocytic leukemia

Geffen Kleinstern, Abdul Rishi, Sara J. Achenbach, Kari G. Rabe, Neil E. Kay, Tait D. Shanafelt, Wei Ding, Joe F. Leis, Aaron D. Norman, Timothy G. Call, …
Journal of the American Academy of Dermatology, Vol.83(6), pp.1581-1589
12/2020
DOI: 10.1016/j.jaad.2020.06.1024
PMCID: PMC7669637
PMID: 32682027
url
https://www.ncbi.nlm.nih.gov/pmc/articles/7669637View
Open Access

Abstract

The incidence of cutaneous squamous cell carcinoma (SCC) in patients with chronic lymphocytic leukemia (CLL) is significantly higher compared with age- and sex-matched controls. To evaluate the association of factors associated with SCC risk. Clinical CLL and SCC data were obtained from Mayo Clinic CLL Resource and self-reported questionnaires among patients with newly diagnosed CLL. We computed the CLL International Prognostic Index (CLL-IPI) from CLL prognostic factors, and a polygenic risk score from SCC susceptibility variants. We used Cox regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Among 1269 patients with CLL, the median follow-up was 7 years, and SCC subsequently developed in 124 patients. Significant associations with SCC risk were history of skin cancer (HR=4.80; 95% CI: 3.37-6.83), CLL-IPI (HR=1.42; 95% CI: 1.13-1.80), and polygenic risk score (HR=2.58; 95% CI: 1.50-4.43). In a multivariable model, these factors were independent predictors (C statistic = 0.69; 95% CI: 0.62-0.76). T-cell immunosuppressive treatments were also associated with SCC risk (HR=2.29; 95% CI: 1.47-3.55; adjusted for age, sex, and prior SCC). The sample size decreases when combining all risk factors in a single model. SCC risk includes history of skin cancer, an aggressive disease at time of CLL diagnosis, receiving T-cell immunosuppressive treatments, and high polygenic risk score. Future studies should develop prediction models that include these factors to improved screening guidelines.
chronic lymphocytic leukemia cutaneous squamous cell carcinoma

Details

Metrics

Logo image