Cause-Specific Mortality and Prognostic Impact of Comorbidity in Japanese Patients With Chronic Lymphocytic Leukemia

IF 3.1 2区医学 Q2 ONCOLOGY Cancer Medicine Pub Date : 2025-01-28 DOI:10.1002/cam4.70613

Daisuke Ikeda, Takuya Nunomura, Tsuyoshi Muta, Kosei Matsue

{"title":"Cause-Specific Mortality and Prognostic Impact of Comorbidity in Japanese Patients With Chronic Lymphocytic Leukemia","authors":"Daisuke Ikeda, Takuya Nunomura, Tsuyoshi Muta, Kosei Matsue","doi":"10.1002/cam4.70613","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Due to its rarity, there are very limited data available on the cause of death (COD) and its association with comorbidities in Japanese chronic lymphocytic leukemia (CLL) patients.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>To investigate the prevalence of comorbidities and their impact on cause-specific mortality, we retrospectively reviewed 121 Japanese patients with CLL.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>The median age was 69 years, with 47.9% having at least one comorbidity listed in the Charlson Comorbidity Index (CCI), and 12.4% were multimorbid. With a median follow-up of 74 months, the 5- and 10-year overall survival rates were 80.6% and 60.1%, respectively. Among the 44 deaths observed, CLL progression was the leading COD (38.6%), which together with infections and other malignancies accounted for nearly 80%. Patients with higher CCI risk categories had significantly higher 5-year all-cause mortality (CCI 1–2: 22.9% and ≥ 3: 31.4%) and non-CLL-specific mortality (CCI 1–2: 18.8% and ≥ 3: 31.4%) compared to those without (CCI 0: 12.6%, <i>p</i> = 0.005; 3.5%, <i>p</i> < 0.001, respectively), whereas CLL-specific mortality was not influenced. On multivariate analysis, age and CCI retained a significant prognostic impact on all-cause mortality (hazard ratio [HR] 1.08, <i>p</i> < 0.001 and HR 1.88, <i>p</i> = 0.004, respectively) and non-CLL-specific mortality (HR 1.12, <i>p</i> < 0.001 and HR 3.81, <i>p</i> < 0.001, respectively).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Our study showed that CLL itself was the leading COD, and comorbidity burden was associated with non-CLL-specific deaths. This highlights the importance of better disease control and effective management of comorbidities.</p>\n </section>\n </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 3","pages":""},"PeriodicalIF":3.1000,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773378/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cancer Medicine","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/cam4.70613","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Due to its rarity, there are very limited data available on the cause of death (COD) and its association with comorbidities in Japanese chronic lymphocytic leukemia (CLL) patients.

Methods

To investigate the prevalence of comorbidities and their impact on cause-specific mortality, we retrospectively reviewed 121 Japanese patients with CLL.

Results

The median age was 69 years, with 47.9% having at least one comorbidity listed in the Charlson Comorbidity Index (CCI), and 12.4% were multimorbid. With a median follow-up of 74 months, the 5- and 10-year overall survival rates were 80.6% and 60.1%, respectively. Among the 44 deaths observed, CLL progression was the leading COD (38.6%), which together with infections and other malignancies accounted for nearly 80%. Patients with higher CCI risk categories had significantly higher 5-year all-cause mortality (CCI 1–2: 22.9% and ≥ 3: 31.4%) and non-CLL-specific mortality (CCI 1–2: 18.8% and ≥ 3: 31.4%) compared to those without (CCI 0: 12.6%, p = 0.005; 3.5%, p < 0.001, respectively), whereas CLL-specific mortality was not influenced. On multivariate analysis, age and CCI retained a significant prognostic impact on all-cause mortality (hazard ratio [HR] 1.08, p < 0.001 and HR 1.88, p = 0.004, respectively) and non-CLL-specific mortality (HR 1.12, p < 0.001 and HR 3.81, p < 0.001, respectively).

Conclusions

Our study showed that CLL itself was the leading COD, and comorbidity burden was associated with non-CLL-specific deaths. This highlights the importance of better disease control and effective management of comorbidities.

Abstract Image

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

日本慢性淋巴细胞白血病患者共病的病因特异性死亡率和预后影响

背景：由于其罕见性，关于日本慢性淋巴细胞白血病（CLL）患者的死亡原因（COD）及其与合并症的关系的数据非常有限。方法：为了调查合并症的患病率及其对原因特异性死亡率的影响，我们回顾性分析了121名日本CLL患者。结果：中位年龄为69岁，其中47.9%的患者至少有一种Charlson合并症指数（CCI）所列的合并症，12.4%的患者为多病。中位随访时间为74个月，5年和10年总生存率分别为80.6%和60.1%。在观察到的44例死亡中，CLL进展是主要的死亡原因（38.6%），与感染和其他恶性肿瘤一起占近80%。CCI风险分类较高的患者5年全因死亡率（CCI 1-2: 22.9%和≥3:31 .4%）和非cll特异性死亡率（CCI 1-2: 18.8%和≥3:31 .4%）显著高于无CCI风险分类的患者(CCI 0: 12.6%, p = 0.005；结论：我们的研究表明，CLL本身是主要的COD，合并症负担与非CLL特异性死亡相关。这突出了更好的疾病控制和有效管理合并症的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.