Comorbidity Burden and Use of Concomitant Medications at CML Diagnosis: A Retrospective Analysis of 527 Patients From the Polish Adult Leukemia Group Registry

Góra‐Tybor, Joanna; Sacha, Tomasz; Wącław, Joanna; Niesiobedzka-Krezel, Joanna; Grzybowska–Izydorczyk, Olga; Mędraś, M; Dereń-Wagemann, Izabela; Patkowska, Elżbieta; Seferyńska, Ilona; Lewandowski, Krzysztof; Wache, Anna; Blajer-Olszewska, Beata; Wątek, Marzena; Kotwica-Mojzych, Katarzyna; Wasilewska, Ewa; Warzocha, Krzysztof; Jamroziak, Krzysztof

doi:10.1016/j.clml.2018.05.001

“…This finding led to a Framingham score of 12.8% (compared with 8.7% average for the US population), and 17% had a history of coronary heart disease. 3 Others have reported similar data, 4,5 with the incidence of comorbidities and number of concomitant medications increasing with age. 6 For example, hypertension was reported for 62% of patients age >75 years.…”

Section: Learning Objectivesmentioning

confidence: 73%

How to manage CML patients with comorbidities

Cortés

¹

2020

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Patients with chronic myeloid leukemia (CML) often have comorbidities, at an incidence that might be higher than in the general population. Because of the favorable outcome of most patients with CML treated with tyrosine kinase inhibitors (TKIs), a greater number of comorbidities might be the most significant adverse feature for long-term survival. The presence of comorbidities may also affect the risk of developing adverse events with TKIs. This effect is perhaps best exemplified by the risk of developing arterio-occlusive events, which is greatest for patients who have other risk factors for such events, with the risk increasing with higher numbers of comorbidities. The coexistence of comorbidities in patients with CML not only may affect TKI selection but also demands close monitoring of the overall health condition of the patient to optimize safety and provide the opportunity for an optimal outcome to such patients. With optimal, holistic management of leukemia and all other conditions afflicting them, patients with CML and comorbidities may aim for a near-normal life expectancy, just as the more select patients enrolled in clinical trials now enjoy.

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“…This finding led to a Framingham score of 12.8% (compared with 8.7% average for the US population), and 17% had a history of coronary heart disease. 3 Others have reported similar data, 4,5 with the incidence of comorbidities and number of concomitant medications increasing with age. 6 For example, hypertension was reported for 62% of patients age .75 years.…”

mentioning

confidence: 73%

How to manage CML patients with comorbidities

Cortes

¹

2020

Blood

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Patients with chronic myeloid leukemia (CML) often have comorbidities, at an incidence that might be higher than in the general population. Because of the favorable outcome of most patients with CML treated with tyrosine kinase inhibitors (TKIs), a greater number of comorbidities might be the most significant adverse feature for long-term survival. The presence of comorbidities may also affect the risk of developing adverse events with TKIs. This effect is perhaps best exemplified by the risk of developing arterio-occlusive events, which is greatest for patients who have other risk factors for such events, with the risk increasing with higher numbers of comorbidities. The coexistence of comorbidities in patients with CML not only may affect TKI selection but also demands close monitoring of the overall health condition of the patient to optimize safety and provide the opportunity for an optimal outcome to such patients. With optimal, holistic management of leukemia and all other conditions afflicting them, patients with CML and comorbidities may aim for a near-normal life expectancy, just as the more select patients enrolled in clinical trials now enjoy.

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“…Patients with CML often have another medical condition at a higher incidence than in the general population. Some studies have reported that nearly 50% of CML patients had at least one comorbid condition [ 21 – 23 ]. Prominently, the overall survival was significantly lower for those with comorbidities compared to those without comorbidities at the time of their leukemia diagnosis, as reported in a randomized trial of 1519 patients in the CML study IV [ 15 ].…”

Section: Prevalence Of Comorbidities In CML Patients and Impact On Ou...mentioning

confidence: 99%

Defining Higher-Risk Chronic Myeloid Leukemia: Risk Scores, Genomic Landscape, and Prognostication

Shahrin

¹

,

Wadham

²

,

Branford

³

2022

Curr Hematol Malig Rep

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Purpose of Review The chronic myeloid leukemia (CML) treatment success story is incomplete as some patients still fail therapy, leading to end-stage disease and death. Here we discuss recent research into CML incidence, the role of comorbidities on survival and detecting patients at risk of failing therapy. Recent Findings The incidence of CML has fallen markedly in high social-demographic index (SDI) regions of the world but there is disturbing evidence that this is not the case in low and low-middle SDI countries. Now that CML patients more frequently die from their co-morbid conditions than from CML the Adult Comorbidity Evaluation-27 score can assist in risk assessment at diagnosis. Non-adherence to therapy contributes greatly to treatment failure. A good doctor-patient relationship and social support promote good adherence, but patient age, gender, and financial burden have negative effects, suggesting avenues for intervention. Mutations in cancer-associated genes adversely affect outcome and their detection at diagnosis may guide therapeutic choice and offer non-BCR::ABL1 targeted therapies. A differential gene expression signature to assist risk detection is a highly sought-after diagnostic tool being actively researched on several fronts. Summary Detecting patients at risk of failing therapy is being assisted by recent technological advances enabling highly sensitive genomic and expression analysis of insensitive cells. However, patient lifestyle, adherence to therapy, and comorbidities are critical risk factors that need to be addressed by interventions such as social and financial support.

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Comorbidity Burden and Use of Concomitant Medications at CML Diagnosis: A Retrospective Analysis of 527 Patients From the Polish Adult Leukemia Group Registry

Cited by 7 publications

References 14 publications

How to manage CML patients with comorbidities

How to manage CML patients with comorbidities

How to manage CML patients with comorbidities

Defining Higher-Risk Chronic Myeloid Leukemia: Risk Scores, Genomic Landscape, and Prognostication

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