Comparison of younger versus older B‐cell chronic lymphocytic leukemia patients for clinical presentation and prognosis. A retrospective study of 53 cases

Molica, Stefano; Brugiatelli, Maura; Callea, Vincenzo; Morabito, Fortunato; Levato, Domenico; Nobile, Francesco; Alberti, Antonio

doi:10.1111/j.1600-0609.1994.tb00648.x

Cited by 31 publications

(16 citation statements)

References 42 publications

(18 reference statements)

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“…long lymphocyte doubling time, bone marrow patterns, smoldering CLL 19 ) were able to identify young patients with a longer overall survival. [7][8][9] The present analysis showed that the same biological parameters reported to have an impact on outcome in non-selected CLL cohorts of patients (i.e. ZAP-70 and CD38 expression, IGHV mutational status and FISH cytogenetic abnormalities) applied to patients ≤55 years, and that these factors retained their independent impact in this subgroup of patients individually stratified according to age, gender and Rai stage.…”

mentioning

confidence: 72%

Chronic lymphocytic leukemia in young individuals revisited

Delgado

Villamor

2014

Haematologica

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confidence: 72%

Chronic lymphocytic leukemia in young individuals revisited

Delgado

Villamor

2014

Haematologica

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“…[22][23][24][25] Due to these profound changes, data from historical reports on clinical outcomes of younger patients with CLL are of uncertain relevance in the modern era. 6,[8][9][10][11] In the present study, we aim to describe the clinical characteristics, time to first treatment and overall survival of CLL patients ≤55 years old in the current era.…”

Section: Introductionmentioning

confidence: 99%

“…<200 patients) and are more than two decades old. 6,[8][9][10][11] The most recent and largest series was reported in 1999 and included 204 patients. 7 The past decade has been a time of tremendous change in the clinical care of patients with CLL.…”

Section: Introductionmentioning

confidence: 99%

“…5 Populationbased studies from Europe also indicate that between 7% and 20% of patients with CLL are <55 years of age at diagnosis. 2,[6][7][8][9] These retrospective studies have described the clinical characteristics of younger patients with CLL, and have compared these to the characteristics of older CLL patients. These historical series were small (e.g.…”

Section: Introductionmentioning

confidence: 99%

“…The median overall survival of their cohort was 12 years. In 1994, Molica et al 8 published their experience of 53 young CLL patients. There were no significant differences in traditional prognostic factors between these patients and older adults; the median overall survival was 7.1 years compared to 4.1 in the older age group.…”

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confidence: 99%

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Chronic lymphocytic leukemia in young (<= 55 years) patients: a comprehensive analysis of prognostic factors and outcomes

et al. 2013

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ABSTRACTto evaluate the experience of CLL patients who were ≤55 years of age at the time of diagnosis. The threshold of ≤55 years was selected to classify age based on a similar cutoff used to define young CLL patients in historical studies. 5,7,29,30 Patients diagnosed with CLL between January 1995 and April 2012 and who fulfilled the 1996 criteria for CLL 31 and/or the World Health Organization (WHO) criteria for small lymphocytic lymphoma 32 were included in this analysis. Rai stage was ascertained within 12 months of the initial diagnosis. Since FISH results can change during the course of disease or after treatment, 33 only pre-treatment FISH results were used in this study. To adjust for potential referral bias, we compared the characteristics of patients who resided within 120 miles of the Mayo Clinic (excluding the twin cities of Minneapolis and St. Paul) to those who resided >120 milesaway. 34,35 The clinical characteristics and outcomes of CLL patients ≤55 years old were compared to those of CLL patients >55 years old. To further explore associations with patients with young onset CLL, those ≤aged 55 years were also divided into three groups based on their age at diagnosis: (i) ≤45 years, (ii) 46-50 years, and (iii) 51-55 years. The overall survival of patients ≤55 years old was also compared to that of the age-and sex-matched normal population of the state of Minnesota. The Mayo Clinic Institutional Review Board approved this study. Statistical analysisPatients' characteristics are summarized using medians and ranges for continuous variables and frequencies (percentages) for categorical variables. Overall survival was defined as time from diagnosis to date of death due to any cause or last follow-up time, whichever occurred first. Time to first treatment was defined as the time between the date of diagnosis and the date of initiation of treatment or date of last follow-up at which the patient was known to be untreated. Since the indications for treatment under both the 1996 31 and 2008 36 consensus criteria are identical, the indications to initiate treatment were consistent throughout the entire study interval. Expected survival was calculated using the cohort (Hakulinen) method 37 with estimates based on the age-and sexmatched Minnesota population.38 P values <0.05 were considered statistically significant. All statistical analyses were conducted using the SAS 9.2 software package (SAS Institute, Cary, NC, USA). More details on the methods and statistical analysis can be found in the Online Supplementary Appendix. Results Baseline characteristics of patients ≤ 55 years of age relative to those >55 years oldBetween January 1, 1995 and April 9, 2012, 844 patients ≤55 years old (median age, 50 years) with CLL were seen at the Mayo Clinic. A comparison of the baseline characteristics and prognostic profile of these patients relative to the 2324 CLL patients >55 years old (median age, 67 years) seen at the Mayo Clinic during the same time period is shown in Table 1. When compared to patients >55 years ol...

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The National Cancer Data Base Report on age, gender, treatment, and outcomes of patients with chronic lymphocytic leukemia

Diehl

Karnell

Menck

1999

Cancer

109

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BACKGROUND The natural history of chronic lymphocytic leukemia (CLL) is changing, although the reasons (potential changes in the disease's biology or in patterns in patient characteristics, treatment, or referral) are unclear. METHODS This report uses National Cancer Data Base (NCDB) data, which reflect a hospital‐based patient population from a broad spectrum of hospitals in the United States. Age, gender, race/ethnicity, income, treatment, overall survival, and relative survival were evaluated according to time period (1985–1990 and 1991–1995). Comparisons were made with U.S. population figures for 1990 and with series published over the last 70 years. RESULTS CLL comprised 22.6% of the 108,396 cases of leukemia in the data base. The risk of developing CLL increased progressively with age and did not plateau; the average age was 69.6 years. At the time of initial diagnosis, 60.5% of patients received no treatment (this proportion increased from 58.1% to 62.7% between the 2 time periods). Overall survival was 48.2% at 5 years and 22.5% at 10 years. The 5‐year relative survival was 69.5%, 72.2%, 63.1%, and 41.7% for age groups <40, 40–59, 60–79, and 80+ years, respectively; these rates indicated that CLL, and not comorbid disease, caused the greatest percentage of deaths. CONCLUSIONS The risk of developing CLL increases progressively with age without plateauing and is 2.8 times higher for older men than for older women. There is an increasing trend toward no treatment at the time of initial diagnosis. Long term overall survival of CLL patients is poor. CLL is a more fatal disease among older individuals because of the disease itself, not because of comorbid conditions. Cancer 1999;86:2684–92. © 1999 American Cancer Society.

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Comparison of younger versus older B‐cell chronic lymphocytic leukemia patients for clinical presentation and prognosis. A retrospective study of 53 cases

Cited by 31 publications

References 42 publications

Chronic lymphocytic leukemia in young individuals revisited

Chronic lymphocytic leukemia in young individuals revisited

Chronic lymphocytic leukemia in young (<= 55 years) patients: a comprehensive analysis of prognostic factors and outcomes

The National Cancer Data Base Report on age, gender, treatment, and outcomes of patients with chronic lymphocytic leukemia

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