Mapping Comorbidity in CLL: Impact on Prognostic Factors, Treatment Patterns and Causes of Death

[Jm954]

Dec 9th 2019 ASH Poster

Lots of us have other illnesses (co-morbidities) as well as CLL and this group looked at the impact of these on survival. The photo shows the HR (hazard ratio) for each condition, the mark to the right of the line shows reduced survival. Unfortunately, all co-morbitities showed an increase likelihood of reduced survival with some such as kidney disease, significantly so.

Side A shows CLL related mortality with those conditions and B shows CLL unrelated mortality in CLL patients with specific co-morbidities compared with CLL patients without the same co-morbidities.

"In chronic lymphocytic leukemia (CLL), very few randomized clinical trials include patients who are older or have significant comorbidity, despite this group constituting a large proportion of the CLL-population. Therefore, detailed data on the association of specific comorbidities with CLL-prognosis are missing and decisions on treatment and follow-up are poorly informed in comorbid patients.

Here they present data on the association of comorbidity with prognostic factors, treatment patterns and causes of death in patients from the world’s largest cohort of unselected CLL-patients.

Unmutated IGHV status was associated with inferior TFS for all patients regardless of age and comorbidity burden (range of HRs 1.47-3.70), while IGHV status was associated with inferior OS for non-comorbid patients only (range of HRs 1.43-1.66). Of comorbid patients who died from CLL-related causes, 59% had not received treatment for CLL, compared with 43% among non-comorbid patients.

All individual types of comorbidity were associated with increased all-cause mortality and most also with higher CLL-related mortality.

Improved management is warranted for comorbid CLL-patients, who should be prioritized in clinical trials of agents with high tolerability to further inform treatment guidelines and reduce CLL-related mortality for these patients."

More detail here: ash.confex.com/ash/2019/web...

Jackie

[Jm954 Administrator]

Scott, I'm going to resist the temptation to ask what cooties are and they are not on the list!

[Smakwater]

Looks like no one gets a new liver, I mean gets to live forever.

JM