1. Comorbidities at Diagnosis, Survival, and Cause of Death in Patients with Chronic Lymphocytic Leukemia: A Population-Based Study
- Author
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Villavicencio, Alicia, Solans, Marta, Zacarías-Pons, Lluís, Vidal, Anna, Puigdemont, Montse, Roncero, Josep Maria, Saez, Marc, Marcos-Gragera, Rafael, Universitat Autònoma de Barcelona, Institut Català de la Salut, [Villavicencio A] Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Catalan Institute of Oncology, Girona, Spain. Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain. Descriptive Epidemiology, Genetics and Cancer Prevention Group, Biomedical Research Institute (IDIBGI), Girona, Spain. [Solans M] Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain. Descriptive Epidemiology, Genetics and Cancer Prevention Group, Biomedical Research Institute (IDIBGI), Girona, Spain. Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. [Zacarías-Pons Ll] Research Group on Aging, Disability and Health, Girona Biomedical Research Institute (IDIBGI), Girona, Spain. [Vidal A, Puigdemont M] Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Catalan Institute of Oncology, Girona, Spain. Descriptive Epidemiology, Genetics and Cancer Prevention Group, Biomedical Research Institute (IDIBGI), Girona, Spain. [Roncero JM] Departament d’Hematologia, Hospital Universitari de Girona Doctor Josep Trueta, Institut Català de la Salut (ICS), Girona, Spain. [Saez M] Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain. Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. [Marcos-Gragera R] Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Catalan Institute of Oncology, Girona, Spain. Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain. Descriptive Epidemiology, Genetics and Cancer Prevention Group, Biomedical Research Institute (IDIBGI), Girona, Spain. Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. Josep Carreras Leukemia Research Institute, Badalona, Spain, and Hospital Universitari de Girona Dr Josep Trueta
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Multivariate analysis ,Other subheadings::Other subheadings::/epidemiology [Other subheadings] ,Health, Toxicology and Mutagenesis ,Chronic lymphocytic leukemia ,lcsh:Medicine ,Comorbidity ,0302 clinical medicine ,immune system diseases ,Cause of Death ,hemic and lymphatic diseases ,Medicine ,ambiente y salud pública::salud pública::factores epidemiológicos::comorbilidad [ATENCIÓN DE SALUD] ,Cause of death ,education.field_of_study ,Leucèmia limfoide ,Relative survival ,Otros calificadores::Otros calificadores::/epidemiología [Otros calificadores] ,Leucèmia limfoide - Epidemiologia ,Leucèmia limfoide -- Mortalitat ,030220 oncology & carcinogenesis ,neoplasias::neoplasias por tipo histológico::leucemia::leucemia linfoide::leucemia de células B::leucemia linfocítica crónica de células B [ENFERMEDADES] ,medicine.medical_specialty ,Population ,Mort - Causes ,causes of death ,comorbidities ,survival ,Article ,03 medical and health sciences ,Comorbiditat ,Diabetes mellitus ,Internal medicine ,Humans ,Health Care Quality, Access, and Evaluation::Quality of Health Care::Epidemiologic Factors::Comorbidity [HEALTH CARE] ,education ,Proportional Hazards Models ,business.industry ,lcsh:R ,Public Health, Environmental and Occupational Health ,medicine.disease ,Leukemia, Lymphocytic, Chronic, B-Cell ,Cancer registry ,population-based ,Lymphocytic leukemia ,Neoplasms::Neoplasms by Histologic Type::Leukemia::Leukemia, Lymphoid::Leukemia, B-Cell::Leukemia, Lymphocytic, Chronic, B-Cell [DISEASES] ,Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Mortality::Cause of Death [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT] ,Lymphocytic leukemia -- Mortality ,Spain ,chronic lymphocytic leukemia ,business ,técnicas de investigación::métodos epidemiológicos::recopilación de datos::estadísticas vitales::mortalidad::causas de muerte [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS] ,030215 immunology - Abstract
This study aimed to examine the prevalence of comorbidities in patients diagnosed with chronic lymphocytic leukemia (CLL), and to assess its influence on survival and cause-specific mortality at a population-based level. Incident CLL cases diagnosed in the Girona province (Spain) during 2008&ndash, 2016 were extracted from the Girona Cancer Registry. Rai stage and presence of comorbidities at diagnosis, further categorized using the Charlson comorbidity index (CCI), were obtained from clinical records. Observed (OS) and relative survival (RS) were estimated and Cox&rsquo, s proportional hazard models were used to explore the impact of comorbidity on mortality. Among the 400 cases included in the study, 380 (99.5%) presented at least one comorbidity at CLL diagnosis, with diabetes without end organ damage (21%) being the most common disease. 5-year OS and RS were 68.8 (95% CI: 64.4&ndash, 73.6) and 99.5 (95% CI 3.13&ndash, 106.0), respectively, which decreased markedly with increasing CCI, particularly in patients with CCI &ge, 3. Multivariate analysis identified no statistically significant association between the CCI and overall CLL-related or CLL-unrelated mortality. In conclusion, a high CCI score negatively influenced the OS and RS of CLL patients, yet its effect on mortality was statistically non-significant when also considering age and the Rai stage.
- Published
- 2021
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