Improving survival in patients with chronic lymphocytic leukemia (1980-2008): the Hospital Clinic of Barcelona experience

被引:117
作者
Abrisqueta, Pau [1 ]
Pereira, Arturo [2 ]
Rozman, Ciril [3 ]
Aymerich, Marta [4 ]
Gine, Eva [1 ]
Moreno, Carol [1 ]
Muntanola, Ana [1 ]
Rozman, Maria [4 ]
Villamor, Neus [4 ]
Hodgson, Kate [1 ]
Campo, Elias [4 ]
Bosch, Francesc [1 ]
Montserrat, Emili [1 ]
机构
[1] Univ Barcelona, Dept Hematol, Inst Hematol & Oncol, Barcelona, Spain
[2] Univ Barcelona, Hemotherapy & Blood Bank, Barcelona, Spain
[3] Univ Barcelona, Hosp Clin Barcelona, Barcelona, Spain
[4] Univ Barcelona, IDIBAPS, Hematopathol Unit, Barcelona, Spain
关键词
FLUDARABINE PLUS CYCLOPHOSPHAMIDE; PROGRESSION-FREE SURVIVAL; PROGNOSTIC FACTORS; NATURAL-HISTORY; INITIAL THERAPY; CLL; RITUXIMAB; DIAGNOSIS; TRIAL; STAGE;
D O I
10.1182/blood-2009-04-214346
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Whether advances in treatment are prolonging survival of patients with chronic lymphocytic leukemia (CLL) is unclear. We analyzed presentation patterns and survival over time in 929 patients followed from 1980 to 2008 at the Hospital Clinic of Barcelona. The 5- and 10-year relative survival ( adjusted for the expected survival in the general population) was estimated in patients seen in 2 periods of time: 1980-1994 (n = 451) and 19952004 (n = 365). We found that CLL short-ens life expectancy in all age groups independently of clinical features at diagnosis. Nevertheless, survival is improving, particularly in some groups of patients. Thus, relative survival was significantly higher in the 1995-2004 cohort than in the 1980-1994 group both at 5 years ( incidence rate ratio [IRR] = 0.46; P = .004) and 10 years (IRR = 0.65; P = .007) from diagnosis. The improved survival was largely due to a decrease in CLL-attributable mortality in patients younger than 70 years in Binet stage B or C at diagnosis (IRR = 0.40; P = .001 at 5 years; IRR = 0.33; P < .001 at 10 years). These results suggest that newer treatments are changing the prognosis of CLL, particularly in younger patients with advanced disease, whereas no improvement is yet observed in older subjects or those with lower-risk disease. ( Blood. 2009; 114: 2044-2050)
引用
收藏
页码:2044 / 2050
页数:7
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