Medical history and lifestyle factors have limited impact on time-to-first-treatment in patients with chronic lymphocytic leukemia

EJHaem Pub Date : 2024-08-27 DOI:10.1002/jha2.1000
Ingrid Glimelius, Geffen Kleinstern, Dennis P. Robinson, Larry Mansouri, Klaus Rostgaard, Henrik Hjalgrim, Carsten Utoft Niemann, Mattias Mattsson, Kari G. Rabe, Paul J. Hampel, Sameer A. Parikh, Richard Rosenquist, James R. Cerhan, Susan L. Slager, Karin E. Smedby
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Abstract

Background

Chronic lymphocytic leukemia (CLL) is a heterogeneous disease. Whereas some patients have an indolent disease, others experience an aggressive course and early death. Our aim was to investigate if modifiable and non-modifiable medical history and lifestyle factors prior to diagnosis had an impact on the natural course of the disease.

Method

In 1154 CLL patients, we assessed if the weight, physical activity, smoking, and alcohol consumption or non-modifiable characteristics including family history of lymphoid malignancy and medical history were associated with time-to-first-treatment (TTFT) and adjusted all results for the CLL-International Prognostic Index (CLL-IPI).

Results

TTFT was shorter for patients with high/very high-risk CLL-IPI than those with low/intermediate risk CLL-IPI. In the adjusted analysis we did not find additional impact on TTFT besides CLL-IPI from any environmental characteristics assessed.

Conclusions

We found limited impact of environmental factors on the natural course of CLL (measured as the TTFT in treatment naïve patients) providing valuable knowledge, and potential relief, to share with patients at the time of diagnosis.

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病史和生活方式因素对慢性淋巴细胞白血病患者首次治疗时间的影响有限
背景 慢性淋巴细胞白血病(CLL)是一种异质性疾病。有些患者病情较轻,有些患者则病情凶险,很早就会死亡。我们的目的是研究确诊前可改变和不可改变的病史和生活方式因素是否会对疾病的自然病程产生影响。 方法 在 1154 名 CLL 患者中,我们评估了体重、体力活动、吸烟和饮酒量或不可改变的特征(包括淋巴恶性肿瘤家族史和病史)是否与首次治疗时间(TTFT)相关,并根据 CLL 国际预后指数(CLL-IPI)调整了所有结果。 结果 CLL-IPI 高危/极高危患者的首次治疗时间短于 CLL-IPI 低危/中危患者。在调整后的分析中,我们没有发现除 CLL-IPI 以外的其他环境因素对 TTFT 的影响。 结论 我们发现环境因素对 CLL 自然病程(以治疗新患者的 TTFT 衡量)的影响有限,这为我们在诊断时与患者分享宝贵的知识和潜在的缓解提供了可能。
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