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Increased incidence of hematologic malignancies in first-degree relatives of patients with chronic lymphocytic
1Department of Medicine, Mount Sinai School of Medicine, New York, New York 10029.
Insights
Family history of hematologic malignancy is more common in chronic lymphocytic leukemia (CLL) patients than previously thought. A significant portion of CLL patients have relatives with blood cancers, suggesting a potential genetic predisposition.
Area of Science:
- Hematology
- Oncology
- Genetics
Background:
- Chronic lymphocytic leukemia (CLL) cases in multiple family members are rare.
- Family members of CLL patients may face a higher risk of hematologic malignancies.
Purpose of the Study:
- To investigate the prevalence of family history of malignancy in patients diagnosed with chronic lymphocytic leukemia (CLL).
- To explore potential links between family history, specific lymphoid malignancies, and ethnic background in CLL patients.
Main Methods:
- Retrospective review of medical charts for 29 CLL patients diagnosed between 1987-1989.
- Direct questioning of living patients regarding family history of any malignancy.
- Analysis of serum immunoglobulin levels and lymphocyte kappa light chain expression.
Main Results:
- 34% (10 of 29) of CLL patients had a first-degree relative with a hematologic malignancy.
- 3 patients had a first-degree relative with CLL, including identical twins.
- No significant differences in serum immunoglobulin levels or kappa light chain expression were found between patients with and without a family history.
- A majority of the study cohort were of Jewish origin from Eastern Europe, with 70% of those with a family history originating from Eastern Europe.
Conclusions:
- A notable proportion of CLL patients report a family history of hematologic malignancy, challenging the notion of its rarity.
- While a family history of CLL was observed, the study did not find differences in immunoglobulin or light chain expression.
- The high prevalence of Eastern European Jewish ancestry in the cohort warrants further investigation into potential genetic factors influencing lymphoid malignancies in this population.
Abstract:
Cases of leukemia in more than one family member occur rarely. Family members of patients with chronic lymphocytic leukemia (CLL) may, however, be at increased risk of hematologic malignancy. The charts of all patients with CLL (29) seen by the author from 1987 through 1989 were reviewed and living patients specifically questioned about family history of malignancy. Ten of the 29 (34%) had a first-degree relative with a hematologic malignancy. Three patients had a first-degree relative with CLL including a pair of identical twins. Two additional patients had a spouse with a lymphoid malignancy. No differences were found in serum immunoglobulin levels between those patients with a family history of hematologic neoplasia and those without. The lymphocytes of the majority of patients with a family history of hematologic neoplasia (60%) expressed kappa light chains as did those without (70%). An increased incidence of lymphoid malignancy has been reported in western Ashkenazi Jews and in particular those of Russian descent. The majority of our cases were of Jewish origin and came from Eastern Europe. Seven of 10 patients with a family history of hematologic neoplasia were from Eastern Europe. In contrast only one of three patients with CLL who had a first-degree relative with CLL was of Jewish origin.