Relationship between co‐morbidities at diagnosis, survival and ultimate cause of death in patients with chronic lymphocytic leukaemia (CLL): a prospective cohort study
Summary The ultimate cause of death for most patients with newly diagnosed chronic lymphocytic leukaemia (CLL) and its relationship to co‐morbid health conditions is poorly defined. We conducted a prospective cohort study that systematically followed 1143 patients diagnosed with CLL between June 200...
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| Veröffentlicht in: | British journal of haematology 2017-08, Vol.178 (3), p.394-402 |
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| container_title | British journal of haematology |
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| creator | Strati, Paolo Parikh, Sameer A. Chaffee, Kari G. Kay, Neil E. Call, Timothy G. Achenbach, Sara J. Cerhan, James R. Slager, Susan L. Shanafelt, Tait D. |
| description | Summary
The ultimate cause of death for most patients with newly diagnosed chronic lymphocytic leukaemia (CLL) and its relationship to co‐morbid health conditions is poorly defined. We conducted a prospective cohort study that systematically followed 1143 patients diagnosed with CLL between June 2002 and November 2014. Comorbid health conditions at the time of CLL diagnosis and their relationship to survival and cause of death were evaluated. Collectively, 1061 (93%) patients had at least one co‐morbid health condition at the time of CLL diagnosis (median number 3). Despite this, 89% of patients had a low‐intermediate Charlson Comorbidity Index score (CCI) at diagnosis. After a median follow‐up of 6 years, 225 patients have died. Death was due to CLL progression in 85 (46%) patients, infection in 14 (8%) patients, other cancer in 35 (19%) patients and comorbid health conditions in 50 (27%) patients. Higher CCI score and a greater number of major comorbid health conditions at the time of CLL diagnosis was associated with shorter non‐CLL specific survival, but not with shorter CLL‐specific survival on multivariate analysis. In conclusion, CLL and CLL‐related complications (infections and second cancers) are the overwhelming cause of death in patients with CLL, regardless of CCI score and number of comorbid health conditions at diagnosis. |
| doi_str_mv | 10.1111/bjh.14785 |
| format | Article |
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The ultimate cause of death for most patients with newly diagnosed chronic lymphocytic leukaemia (CLL) and its relationship to co‐morbid health conditions is poorly defined. We conducted a prospective cohort study that systematically followed 1143 patients diagnosed with CLL between June 2002 and November 2014. Comorbid health conditions at the time of CLL diagnosis and their relationship to survival and cause of death were evaluated. Collectively, 1061 (93%) patients had at least one co‐morbid health condition at the time of CLL diagnosis (median number 3). Despite this, 89% of patients had a low‐intermediate Charlson Comorbidity Index score (CCI) at diagnosis. After a median follow‐up of 6 years, 225 patients have died. Death was due to CLL progression in 85 (46%) patients, infection in 14 (8%) patients, other cancer in 35 (19%) patients and comorbid health conditions in 50 (27%) patients. Higher CCI score and a greater number of major comorbid health conditions at the time of CLL diagnosis was associated with shorter non‐CLL specific survival, but not with shorter CLL‐specific survival on multivariate analysis. In conclusion, CLL and CLL‐related complications (infections and second cancers) are the overwhelming cause of death in patients with CLL, regardless of CCI score and number of comorbid health conditions at diagnosis.</description><identifier>ISSN: 0007-1048</identifier><identifier>EISSN: 1365-2141</identifier><identifier>DOI: 10.1111/bjh.14785</identifier><identifier>PMID: 28580636</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Aged ; Cancer ; Cause of Death ; causes of death ; chronic lymphocytic leukaemia ; Chronic lymphocytic leukemia ; Cohort analysis ; comorbidities ; Comorbidity ; Complications ; Death ; Diagnosis ; Disease Progression ; Female ; Follow-Up Studies ; Health risk assessment ; Hematology ; Humans ; Infections ; Leukemia ; Leukemia, Lymphocytic, Chronic, B-Cell - mortality ; Male ; Middle Aged ; Minnesota - epidemiology ; Multivariate analysis ; Prognosis ; Prospective Studies ; Survival</subject><ispartof>British journal of haematology, 2017-08, Vol.178 (3), p.394-402</ispartof><rights>2017 John Wiley & Sons Ltd</rights><rights>2017 John Wiley & Sons Ltd.</rights><rights>Copyright © 2017 John Wiley & Sons Ltd</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4435-23c03318ce855c0c9c5dba1934bb9d774e039777b922cc09f9fae60526633c923</citedby><cites>FETCH-LOGICAL-c4435-23c03318ce855c0c9c5dba1934bb9d774e039777b922cc09f9fae60526633c923</cites><orcidid>0000-0002-7445-1459</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fbjh.14785$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fbjh.14785$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,776,780,881,1411,1427,27903,27904,45553,45554,46387,46811</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28580636$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Strati, Paolo</creatorcontrib><creatorcontrib>Parikh, Sameer A.</creatorcontrib><creatorcontrib>Chaffee, Kari G.</creatorcontrib><creatorcontrib>Kay, Neil E.</creatorcontrib><creatorcontrib>Call, Timothy G.</creatorcontrib><creatorcontrib>Achenbach, Sara J.</creatorcontrib><creatorcontrib>Cerhan, James R.</creatorcontrib><creatorcontrib>Slager, Susan L.</creatorcontrib><creatorcontrib>Shanafelt, Tait D.</creatorcontrib><title>Relationship between co‐morbidities at diagnosis, survival and ultimate cause of death in patients with chronic lymphocytic leukaemia (CLL): a prospective cohort study</title><title>British journal of haematology</title><addtitle>Br J Haematol</addtitle><description>Summary
The ultimate cause of death for most patients with newly diagnosed chronic lymphocytic leukaemia (CLL) and its relationship to co‐morbid health conditions is poorly defined. We conducted a prospective cohort study that systematically followed 1143 patients diagnosed with CLL between June 2002 and November 2014. Comorbid health conditions at the time of CLL diagnosis and their relationship to survival and cause of death were evaluated. Collectively, 1061 (93%) patients had at least one co‐morbid health condition at the time of CLL diagnosis (median number 3). Despite this, 89% of patients had a low‐intermediate Charlson Comorbidity Index score (CCI) at diagnosis. After a median follow‐up of 6 years, 225 patients have died. Death was due to CLL progression in 85 (46%) patients, infection in 14 (8%) patients, other cancer in 35 (19%) patients and comorbid health conditions in 50 (27%) patients. Higher CCI score and a greater number of major comorbid health conditions at the time of CLL diagnosis was associated with shorter non‐CLL specific survival, but not with shorter CLL‐specific survival on multivariate analysis. In conclusion, CLL and CLL‐related complications (infections and second cancers) are the overwhelming cause of death in patients with CLL, regardless of CCI score and number of comorbid health conditions at diagnosis.</description><subject>Aged</subject><subject>Cancer</subject><subject>Cause of Death</subject><subject>causes of death</subject><subject>chronic lymphocytic leukaemia</subject><subject>Chronic lymphocytic leukemia</subject><subject>Cohort analysis</subject><subject>comorbidities</subject><subject>Comorbidity</subject><subject>Complications</subject><subject>Death</subject><subject>Diagnosis</subject><subject>Disease Progression</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Health risk assessment</subject><subject>Hematology</subject><subject>Humans</subject><subject>Infections</subject><subject>Leukemia</subject><subject>Leukemia, Lymphocytic, Chronic, B-Cell - mortality</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Minnesota - epidemiology</subject><subject>Multivariate analysis</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Survival</subject><issn>0007-1048</issn><issn>1365-2141</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1ktGK1DAUhoMo7rh64QtIwJtdcHZPmrZpvRB0UFcZEESvQ5qe2WZsk26SztA7H8HX8LV8ErPOuqhgbhJOPj7OnxxCHjM4Y2mdN9vujOWiKu6QBeNlscxYzu6SBQCIJYO8OiIPQtgCMA4Fu0-OsqqooOTlgnz_iL2KxtnQmZE2GPeIlmr34-u3wfnGtCYaDFRF2hp1aV0w4RkNk9-Zneqpsi2d-mgGFZFqNQWkbkNbVLGjxtIxmdHGQPcmFXTnnTWa9vMwdk7P8fqM0xeFg1H0ZLVenz6nio7ehRF1NLukdJ3zkYY4tfNDcm-j-oCPbvZj8vnN60-ri-X6w9t3q5frpc5znqJzDZyzSmNVFBp0rYu2UazmedPUrRA5Aq-FEE2dZVpDvak3CksosrLkXNcZPyYvDt5xagZsdQrgVS9Hn1L6WTpl5N831nTy0u1kyYUAwZLg5Ebg3dWEIcrBBI19ryy6KUhWQ8l4leiEPv0H3brJ2xQvUVnG8woySNTpgdLpaYLHzW0zDOT1AMg0APLXACT2yZ_d35K_fzwB5wdgb3qc_2-Sr95fHJQ_AaqZvqs</recordid><startdate>201708</startdate><enddate>201708</enddate><creator>Strati, Paolo</creator><creator>Parikh, Sameer A.</creator><creator>Chaffee, Kari G.</creator><creator>Kay, Neil E.</creator><creator>Call, Timothy G.</creator><creator>Achenbach, Sara J.</creator><creator>Cerhan, James R.</creator><creator>Slager, Susan L.</creator><creator>Shanafelt, Tait D.</creator><general>Blackwell Publishing Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-7445-1459</orcidid></search><sort><creationdate>201708</creationdate><title>Relationship between co‐morbidities at diagnosis, survival and ultimate cause of death in patients with chronic lymphocytic leukaemia (CLL): a prospective cohort study</title><author>Strati, Paolo ; Parikh, Sameer A. ; Chaffee, Kari G. ; Kay, Neil E. ; Call, Timothy G. ; Achenbach, Sara J. ; Cerhan, James R. ; Slager, Susan L. ; Shanafelt, Tait D.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4435-23c03318ce855c0c9c5dba1934bb9d774e039777b922cc09f9fae60526633c923</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Aged</topic><topic>Cancer</topic><topic>Cause of Death</topic><topic>causes of death</topic><topic>chronic lymphocytic leukaemia</topic><topic>Chronic lymphocytic leukemia</topic><topic>Cohort analysis</topic><topic>comorbidities</topic><topic>Comorbidity</topic><topic>Complications</topic><topic>Death</topic><topic>Diagnosis</topic><topic>Disease Progression</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Health risk assessment</topic><topic>Hematology</topic><topic>Humans</topic><topic>Infections</topic><topic>Leukemia</topic><topic>Leukemia, Lymphocytic, Chronic, B-Cell - mortality</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Minnesota - epidemiology</topic><topic>Multivariate analysis</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Survival</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Strati, Paolo</creatorcontrib><creatorcontrib>Parikh, Sameer A.</creatorcontrib><creatorcontrib>Chaffee, Kari G.</creatorcontrib><creatorcontrib>Kay, Neil E.</creatorcontrib><creatorcontrib>Call, Timothy G.</creatorcontrib><creatorcontrib>Achenbach, Sara J.</creatorcontrib><creatorcontrib>Cerhan, James R.</creatorcontrib><creatorcontrib>Slager, Susan L.</creatorcontrib><creatorcontrib>Shanafelt, Tait D.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>British journal of haematology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Strati, Paolo</au><au>Parikh, Sameer A.</au><au>Chaffee, Kari G.</au><au>Kay, Neil E.</au><au>Call, Timothy G.</au><au>Achenbach, Sara J.</au><au>Cerhan, James R.</au><au>Slager, Susan L.</au><au>Shanafelt, Tait D.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Relationship between co‐morbidities at diagnosis, survival and ultimate cause of death in patients with chronic lymphocytic leukaemia (CLL): a prospective cohort study</atitle><jtitle>British journal of haematology</jtitle><addtitle>Br J Haematol</addtitle><date>2017-08</date><risdate>2017</risdate><volume>178</volume><issue>3</issue><spage>394</spage><epage>402</epage><pages>394-402</pages><issn>0007-1048</issn><eissn>1365-2141</eissn><abstract>Summary
The ultimate cause of death for most patients with newly diagnosed chronic lymphocytic leukaemia (CLL) and its relationship to co‐morbid health conditions is poorly defined. We conducted a prospective cohort study that systematically followed 1143 patients diagnosed with CLL between June 2002 and November 2014. Comorbid health conditions at the time of CLL diagnosis and their relationship to survival and cause of death were evaluated. Collectively, 1061 (93%) patients had at least one co‐morbid health condition at the time of CLL diagnosis (median number 3). Despite this, 89% of patients had a low‐intermediate Charlson Comorbidity Index score (CCI) at diagnosis. After a median follow‐up of 6 years, 225 patients have died. Death was due to CLL progression in 85 (46%) patients, infection in 14 (8%) patients, other cancer in 35 (19%) patients and comorbid health conditions in 50 (27%) patients. Higher CCI score and a greater number of major comorbid health conditions at the time of CLL diagnosis was associated with shorter non‐CLL specific survival, but not with shorter CLL‐specific survival on multivariate analysis. In conclusion, CLL and CLL‐related complications (infections and second cancers) are the overwhelming cause of death in patients with CLL, regardless of CCI score and number of comorbid health conditions at diagnosis.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>28580636</pmid><doi>10.1111/bjh.14785</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-7445-1459</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Cancer Cause of Death causes of death chronic lymphocytic leukaemia Chronic lymphocytic leukemia Cohort analysis comorbidities Comorbidity Complications Death Diagnosis Disease Progression Female Follow-Up Studies Health risk assessment Hematology Humans Infections Leukemia Leukemia, Lymphocytic, Chronic, B-Cell - mortality Male Middle Aged Minnesota - epidemiology Multivariate analysis Prognosis Prospective Studies Survival |
| title | Relationship between co‐morbidities at diagnosis, survival and ultimate cause of death in patients with chronic lymphocytic leukaemia (CLL): a prospective cohort study |
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