Abstract
BackgroundLittle is known about the aetiology of chronic lymphocytic leukaemia (CLL). The family medical history is a "genomic tool" capturing interactions of genetic susceptibility, shared environment and common behaviours.MethodsA cohort of 66 consecutives patients with CLL (probands) was studied in a medical oncology practice (W.W.) from 1981 until 2005. A German version of the NCI medical history questionnaire for cancer aetiology was used. Familial clustering analysis was done by comparing the proportion of specific tumours in the first degree relatives of the CLL practice cohort with corresponding proportions of population-based cancer registry data.Results18 (41%) male and 5 (23%) female CLL probands had multiple malignancies, e.g. 2 meningiomas, 7 and 19 years after diagnosis of CLL. 46 (12%) first degree relatives had malignancies with an excess of CLL. Other conspicuous familial associations are CLL with malignancies of the upper GI tract (oesophagus, stomach) and of the nervous system.Conclusion1. Chronic lymphocytic leukaemia clusters in some families like any other disease. Predisposition genes should be searched. 2. Cancer prevention and early detection should be continued in CLL patients because of their longevity and high risk for multiple malignancies. 3. The overrepresentation of upper GI malignancies in first degree relatives of CLL patients calls for targeted oesophago-gastroscopy screening studies.
Highlights
Every human disease clusters in families to some extent
Cancer prevention and early detection should be continued in chronic lymphocytic leukaemia (CLL) patients because of their longevity and high risk for multiple malignancies
The overrepresentation of upper GI malignancies in first degree relatives of CLL patients calls for targeted oesophago-gastroscopy screening studies
Summary
Every human disease clusters in families to some extent. All sites show an excess of cancers of the same site among relatives, with thyroid and colon cancers and lymphocytic leukaemia showing the highest familial risks [1]. Taking the family history of cancer patients is a low technology approach which can be applied all over the world [3]. Methods: A cohort of 66 consecutives patients with CLL (probands) was studied in a medical oncology practice (W.W.) from 1981 until 2005. Familial clustering analysis was done by comparing the proportion of specific tumours in the first degree relatives of the CLL practice cohort with corresponding proportions of population-based cancer registry data. Chronic lymphocytic leukaemia clusters in some families like any other disease.
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