Comorbidities at Diagnosis, Survival, and Cause of Death in Patients with Chronic Lymphocytic Leukemia: A Population-Based Study

Alicia Villavicencio, Marta Solans, Lluís Zacarías-Pons, Anna Vidal, Montse Puigdemont, Josep Maria Roncero, Marc Saez and Rafael Marcos-Gragera
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Alicia Villavicencio: Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Catalan Institute of Oncology, Carrer del Sol 15, 17004 Girona, Spain
Marta Solans: Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, C/Universitat de Girona 10, 17003 Girona, Spain
Lluís Zacarías-Pons: Research Group on Aging, Disability and Health, Girona Biomedical Research Institute (IDIBGI), 17190 Girona, Spain
Anna Vidal: Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Catalan Institute of Oncology, Carrer del Sol 15, 17004 Girona, Spain
Montse Puigdemont: Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Catalan Institute of Oncology, Carrer del Sol 15, 17004 Girona, Spain
Josep Maria Roncero: Hematological Service, Josep Trueta University Hospital, Catalan Institute of Oncology, Avinguda de França, S/N, 17007 Girona, Spain
Marc Saez: Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, C/Universitat de Girona 10, 17003 Girona, Spain
Rafael Marcos-Gragera: Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Catalan Institute of Oncology, Carrer del Sol 15, 17004 Girona, Spain

IJERPH, 2021, vol. 18, issue 2, 1-10

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 2008–2016 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’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: 64.4–73.6) and 99.5 (95% CI 3.13–106.0), respectively, which decreased markedly with increasing CCI, particularly in patients with CCI ≥ 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.

Keywords: chronic lymphocytic leukemia; comorbidities; causes of death; survival; population-based (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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