Comorbid conditions and survival in unselected, newly diagnosed patients with chronic lymphocytic leukemia.

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Comorbid conditions and survival in unselected, newly diagnosed patients with

chronic lymphocytic leukemia.

P Thurmes, T Call, S Slager, C Zent, G , S Schwager, D Bowen, N Kay, and

T Shanafelt

Leuk Lymphoma, January 1, 2008; 49(1): 49-56.

Mayo Clinic College of Medicine, Rochester, MN.

Little is known about the spectrum or frequency of comorbidities in patients

with chronic lymphocytic leukemia (CLL). We investigated the prevalence and

prognostic implications of comorbidities in patients with newly diagnosed CLL.

Local/non-referred patients with CLL evaluated by a hematologist at Mayo Clinic

within 1 year of diagnosis were eligible for this retrospective review. Of 1195

individuals evaluated for newly-diagnosed CLL between 1995 and 2006, 373 (31%)

were local/non-referred. At diagnosis, 89% of these patients had one or more

comorbidities, and 46% had at least one major comorbidity. Twenty-six percent of

patients failed to meet NCI working group guidelines to participate in a

clinical trial. On multi-factor analysis, Rai risk category (1.39 per each risk

category increase; p < 0.0001) and age (1.056 per year increase; p < 0.0001)

were the only factors associated with overall survival. We conclude that,

although common, comorbid conditions are less important than age and stage in

predicting prognosis in newly diagnosed patients with CLL. Clinical trials

evaluating treatments that are designed to be tolerated by patients who do not

meet traditional clinical trial eligibility criteria are needed.

PMID: 18203011