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Conditional survival to assess prognosis in patients with chronic lymphocytic leukemia

  • Biomarkers in chronic lymphocytic leukemia (CLL) allow assessment of prognosis. However, the validity of current prognostic biomarkers based on a single assessment point remains unclear for patients who have survived one or more years. Conditional survival (CS) studies that address how prognosis may change over time, especially in prognostic subgroups, are still rare. We performed CS analyses to estimate 5-year survival in 1-year increments, stratified by baseline disease characteristics and known risk factors in two community-based cohorts of CLL patients (Freiburg University Hospital (n = 316) and Augsburg University Hospital (n = 564)) diagnosed between 1984 and 2021. We demonstrate that 5-year CS probability is stable (app. 75%) for the entire CLL patient cohort over 10 years. While age, sex, and stage have no significant impact on CS, patients with high-risk disease features such as non-mutated IGHV, deletion 17p, and high-risk CLL-IPI have a significantly worse prognosis atBiomarkers in chronic lymphocytic leukemia (CLL) allow assessment of prognosis. However, the validity of current prognostic biomarkers based on a single assessment point remains unclear for patients who have survived one or more years. Conditional survival (CS) studies that address how prognosis may change over time, especially in prognostic subgroups, are still rare. We performed CS analyses to estimate 5-year survival in 1-year increments, stratified by baseline disease characteristics and known risk factors in two community-based cohorts of CLL patients (Freiburg University Hospital (n = 316) and Augsburg University Hospital (n = 564)) diagnosed between 1984 and 2021. We demonstrate that 5-year CS probability is stable (app. 75%) for the entire CLL patient cohort over 10 years. While age, sex, and stage have no significant impact on CS, patients with high-risk disease features such as non-mutated IGHV, deletion 17p, and high-risk CLL-IPI have a significantly worse prognosis at diagnosis, and 5-year CS steadily decreases with each additional year survived. Our results confirm that CLL patients have a stable survival probability with excess mortality and that the prognosis of high-risk CLL patients declines over time. We infer that CS-based prognostic information is relevant for disease management and counseling of CLL patients.show moreshow less

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Metadaten
Author:Pascal Schlosser, Annett Schiwitza, Jonas Klaus, Stefanie Hieke-Schulz, Katarzyna Szarc vel Szic, Justus Duyster, Martin TrepelGND, Katja Zirlik, Martin Schumacher, Rainer ClausORCiDGND
URN:urn:nbn:de:bvb:384-opus4-1116317
Frontdoor URLhttps://opus.bibliothek.uni-augsburg.de/opus4/111631
ISSN:0939-5555OPAC
ISSN:1432-0584OPAC
Parent Title (English):Annals of Hematology
Publisher:Springer Science and Business Media LLC
Type:Article
Language:English
Year of first Publication:2024
Publishing Institution:Universität Augsburg
Release Date:2024/02/27
Tag:General Medicine; Hematology
Volume:103
Issue:5
First Page:1613
Last Page:1622
DOI:https://doi.org/10.1007/s00277-024-05627-w
Institutes:Medizinische Fakultät
Medizinische Fakultät / Universitätsklinikum
Medizinische Fakultät / Lehrstuhl für Innere Medizin mit Schwerpunkt Hämatologie und Onkologie
Medizinische Fakultät / Professur für personalisierte Tumormedizin und molekulare Onkologie
Nachhaltigkeitsziele
Nachhaltigkeitsziele / Ziel 3 - Gesundheit und Wohlergehen
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCC-BY 4.0: Creative Commons: Namensnennung (mit Print on Demand)