Relationship between co-morbidities at diagnosis, survival and ultimate cause of death in patients with chronic lymphocytic leukaemia (CLL): A prospective cohort study

Paolo Strati, Sameer A Parikh, Kari G. Chaffee, Neil Elliot Kay, Timothy G. Call, Sara J. Achenbach, James R Cerhan, Susan L Slager, Tait D. Shanafelt

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
JournalBritish Journal of Haematology
DOIs
StateAccepted/In press - 2017

Fingerprint

B-Cell Chronic Lymphocytic Leukemia
Cause of Death
Cohort Studies
Prospective Studies
Morbidity
Survival
Health
Comorbidity
Lymphoid Leukemia
Second Primary Neoplasms
Infection
Multivariate Analysis

Keywords

  • Causes of death
  • Chronic lymphocytic leukaemia
  • Comorbidities

ASJC Scopus subject areas

  • Hematology

Cite this

@article{a69fc972984b41f5abc4b5545c8423c1,
title = "Relationship between co-morbidities at diagnosis, survival and ultimate cause of death in patients with chronic lymphocytic leukaemia (CLL): A prospective cohort study",
abstract = "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.",
keywords = "Causes of death, Chronic lymphocytic leukaemia, Comorbidities",
author = "Paolo Strati and Parikh, {Sameer A} and Chaffee, {Kari G.} and Kay, {Neil Elliot} and Call, {Timothy G.} and Achenbach, {Sara J.} and Cerhan, {James R} and Slager, {Susan L} and Shanafelt, {Tait D.}",
year = "2017",
doi = "10.1111/bjh.14785",
language = "English (US)",
journal = "British Journal of Haematology",
issn = "0007-1048",
publisher = "Wiley-Blackwell",

}

TY - JOUR

T1 - Relationship between co-morbidities at diagnosis, survival and ultimate cause of death in patients with chronic lymphocytic leukaemia (CLL)

T2 - A prospective cohort study

AU - Strati, Paolo

AU - Parikh, Sameer A

AU - Chaffee, Kari G.

AU - Kay, Neil Elliot

AU - Call, Timothy G.

AU - Achenbach, Sara J.

AU - Cerhan, James R

AU - Slager, Susan L

AU - Shanafelt, Tait D.

PY - 2017

Y1 - 2017

N2 - 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.

AB - 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.

KW - Causes of death

KW - Chronic lymphocytic leukaemia

KW - Comorbidities

UR - http://www.scopus.com/inward/record.url?scp=85020230579&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85020230579&partnerID=8YFLogxK

U2 - 10.1111/bjh.14785

DO - 10.1111/bjh.14785

M3 - Article

C2 - 28580636

AN - SCOPUS:85020230579

JO - British Journal of Haematology

JF - British Journal of Haematology

SN - 0007-1048

ER -