Evidence map›Paper›PMID 27133817›Full record

Trial reportLeukemia2016

Effect of first-line treatment on second primary malignancies and Richter's transformation in patients with CLL.

C Maurer, P Langerbeins, J Bahlo, P Cramer, A M Fink, N Pflug, A Engelke, J von Tresckow, G Kovacs, S Stilgenbauer and 7 more

Abstract readClinical Trial, Phase IIClinical Trial, Phase III
PubMed Publisher
In one paragraph

Trial report in Leukemia, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 1 pooled it
5.6field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 1 synthesis or guideline pooled it, 60 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Trial
  4. Article
  5. Review
  6. Article
  7. Review
  8. Review
  9. Article
  10. Richter Transformation: Clinical Manifestations, Evaluation, and Management.Journal of the advanced practitioner in oncology · 2022
    Article
  11. Can Immunocompetence Be Restored in Chronic Lymphocytic Leukemia?Hematology/oncology clinics of North America · 2021
    Review
  12. Review
  13. Article
  14. Article
  15. Article
  16. Article
  17. Richter transformation in the era of novel agents.Hematology. American Society of Hematology. Education Program · 2018
    Review
  18. Optimizing frontline therapy of CLL based on clinical and biological factors.Hematology. American Society of Hematology. Education Program · 2017
    Review
  19. Article
  20. Chronic lymphocytic leukaemia.Nature reviews. Disease primers · 2017
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors at 6 institutions in 1 country.

C MaurerDepartment I of Internal Medicine and Center of Integrated Oncology Cologne Bonn, University of Cologne, Cologne, Germany.
P LangerbeinsDepartment I of Internal Medicine and Center of Integrated Oncology Cologne Bonn, University of Cologne, Cologne, Germany.
J BahloDepartment I of Internal Medicine and Center of Integrated Oncology Cologne Bonn, University of Cologne, Cologne, Germany.
P CramerDepartment I of Internal Medicine and Center of Integrated Oncology Cologne Bonn, University of Cologne, Cologne, Germany.
A M FinkDepartment I of Internal Medicine and Center of Integrated Oncology Cologne Bonn, University of Cologne, Cologne, Germany.
N PflugDepartment I of Internal Medicine and Center of Integrated Oncology Cologne Bonn, University of Cologne, Cologne, Germany.
A EngelkeDepartment I of Internal Medicine and Center of Integrated Oncology Cologne Bonn, University of Cologne, Cologne, Germany.
J von TresckowDepartment I of Internal Medicine and Center of Integrated Oncology Cologne Bonn, University of Cologne, Cologne, Germany.
G KovacsDepartment I of Internal Medicine and Center of Integrated Oncology Cologne Bonn, University of Cologne, Cologne, Germany.
S StilgenbauerDepartment of Internal Medicine III, University of Ulm, Ulm, Germany.
C-M WendtnerDepartment of Hematology, Oncology, Immunology, Palliative Care, Infectious Diseases and Tropical Medicine, Klinikum Schwabing, Munich, Germany.
L MüllerOncology Leer, Practice for Hematology and Oncology, Leer, Germany.
M RitgenSecond Department of Medicine, University Hospital of Schleswig-Holstein, Campus Kiel, Kiel, Germany.
T SeilerDepartment of Medicine III, University Hospital Großhadern/LMU München, Munich, Germany.
K FischerDepartment I of Internal Medicine and Center of Integrated Oncology Cologne Bonn, University of Cologne, Cologne, Germany.
M HallekDepartment I of Internal Medicine and Center of Integrated Oncology Cologne Bonn, University of Cologne, Cologne, Germany.
B EichhorstDepartment I of Internal Medicine and Center of Integrated Oncology Cologne Bonn, University of Cologne, Cologne, Germany.
University of Cologne · DECologne Excellence Cluster on Cellular Stress Responses in Aging Associated Diseases · DELudwig-Maximilians-Universität München · DEMünchen Klinik Schwabing · DEUniversität Ulm · DEUniversity Hospital Schleswig-Holstein · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

This study aimed to assess the frequency of and the contributing factors for second primary malignancies (SPMs) and Richter's transformations (RTs) following first-line treatment of chronic lymphocytic leukemia within four phase II/III trials of the GCLLSG evaluating fludarabine (F) vs F+cyclophosphamide (FC), chlorambucil vs F, FC without or with rituximab, and bendamustine+R (BR). Among 1458 patients, 239 (16.4%) experienced either an SPM (N=191) or a RT (N=75). Solid tumors (N=115; 43.2% of all second neoplasias) appeared most frequently, followed by RTs (N=75; 28.2%). Patients showed a 1.23-fold increased risk of solid tumors in comparison to the age-matched general population from the German cancer registry. Age>65 (hazard ratio (HR) 2.1; P<0.001), male sex (HR 1.7; P=0.01), co-morbidities (HR 1.6; P=0.01) and number of subsequent treatments⩾1 (HR 12.1; P<0.001) showed an independent adverse prognostic impact on SPM-free survival. Serum thymidine kinase>10 U/l at trial enrollment (HR 3.9; P=0.02), non-response to first-line treatment (HR 3.6; P<0.001) and number of subsequent treatments⩾1 (HR 30.2; P<0.001) were independently associated with increased risk for RT.

Indexed as

AdultAgedAged, 80 and overBendamustine HydrochlorideCase-Control StudiesCell Transformation, NeoplasticChlorambucilCyclophosphamideDisease-Free SurvivalFemaleGermanyHumansLeukemia, Lymphocytic, Chronic, B-CellMaleMiddle AgedNeoplasms, Second PrimaryBendamustine HydrochlorideChlorambucilCyclophosphamidefludarabineVidarabine

Identifiers

PMID27133817
OpenAlexW2461753455

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.