Please use this identifier to cite or link to this item:
http://hdl.handle.net/2445/122083
Title: | Chronic lymphocytic leukemia in the elderly: clinico-biological features, outcomes, and proposal of a prognostic model. |
Author: | Baumann, Tycho Delgado, Julio (Delgado González) Santacruz, Rodrigo Martínez Trillos, Alejandra Royo Moreno, Cristina Navarro López, Alba Pinyol, Magda Rozman, María Pereira Saavedra, Arturo Villamor i Casas, Neus Aymerich Gregorio, Marta López Alcalá, Cristina Carrió, Ana Montserrat Costa, Emilio |
Keywords: | Leucèmia limfocítica crònica Comorbiditat Estudi de casos Chronic lymphocytic leukemia Comorbidity Case studies |
Issue Date: | 24-Jun-2014 |
Publisher: | Ferrata Storti Foundation |
Abstract: | We investigated the clinico-biological features, outcomes, and prognosis of 949 patients with chronic lymphocytic leukemia according to age. No biological differences (cytogenetics by fluorescent in situ hybridization, IGHV, ZAP-70, CD38, NOTCH1, SF3B1) were found across age groups. Elderly patients (>70 years; n=367) presented more frequently with advanced disease (Binet C/Rai III-IV: 10/12% versus 5/5%; P<0.001), were treated less frequently (23.8% versus 41.9% at 3 years; P<0.001) and in most cases did not receive highly effective regimens and thus had a lower overall response rate (49% with 14% having complete responses versus 69% with 31% having complete responses; P<0.001). The elderly patients also had a shorter overall survival (6.6 versus 13.3 years; P<0.001) and higher disease-unrelated mortality (34.9% versus 6.9% at 10 years; P<0.001). However, disease-attributable mortality was not significantly different between younger and older patients. A combination of Binet stage, ZAP-70 level, β2-microglobulin concentration and comorbidity identified two risk groups (low-risk: 0-1 parameters; high-risk: 2-4 parameters) with different overall survivals (median: 6.8 versus 11.4 years, P<0.001). In patients requiring treatment, comorbidity at treatment (Cumulative Illness Rating Scale-T>4; hazard ratio 2.2, P<0.001) and response (treatment failure versus response: hazard ratio 1.60, P<0.04) were the most important prognostic factors for overall survival. In conclusion, in our series, elderly patients with chronic lymphocytic leukemia did not present with any biological features distinct from those of younger patients, but did have a poorer clinical outcome. This study highlights the importance of comprehensive medical care, achieving response to therapy, and specific management strategies for elderly patients with chronic lymphocytic leukemia. |
Note: | Reproducció del document publicat a: https://doi.org/10.3324/haematol.2014.107326 |
It is part of: | Haematologica, 2014, vol. 99, num. 10, p. 1599-15604 |
URI: | http://hdl.handle.net/2445/122083 |
Related resource: | https://doi.org/10.3324/haematol.2014.107326 |
ISSN: | 0390-6078 |
Appears in Collections: | Articles publicats en revistes (Medicina) |
Files in This Item:
File | Description | Size | Format | |
---|---|---|---|---|
644628.pdf | 656.49 kB | Adobe PDF | View/Open |
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.