Chronic lymphocytic leukemia (CLL) patients at a VA medical center: Comorbidity and survival.

Abstract

Listen

Translate article

6602 Background: To determine whether co morbidity indices predict survival in chronic lymphocytic leukemia (CLL) patients (pts). Methods: In an IRB-approved protocol, we reviewed the records of 107 pts diagnosed with CLL at a VA Medical Center from January 2001 to May 2010. Records were reviewed for demographic, clinical, pathological data. ECOG PS, Veteran status (V-Vietnam) treatment status and survival were tabulated. Comorbidity was assessed using Charlson Comorbidity Index (CCI), The Kaplan-Feinstein Index (KFI), the Cumulative Illness Rating Scale (CIRS) and the VA comorbidity Index. We preformed Cox regression analysis to determine predictors of survival. Results: There were 107 pts with a median (M) age of 72 yo (48-94). The M hemoglobin(Hgb) was 13.6 g/dl (7.3-16.7), M WBC 15.4 K/cmm (2.8-289), M platelets 201 K/cmm (50-1077), M blood urea nitrogen (BUN) 19 mg/dL (1-88), M creatinine (Cr) 1.1 mg/dl (0.4-3.6), M lactate dehydrogenase (LDH) 177 IU/L (105-1635), M beta 2-microglobulin 2.3 mg/dl (0.9-8.9) and M BMI 28.7 kg/m2 (15.06-43.1). Early stage pts numbered 94 (88%). The M CCI was 4 (0.8-8.7), M KFI 1 (0-3), M CIRS 15 3 (1-6), M CIRS 16 7 (1-14), M CIRS 17 2 (1-4.5), M VA comorbidity 3 (0-8).106 pts had a PS 0-2. By immunophenotyping 42 ptswere CD38/ ZAP-70 positive. 65 pts (75 %) non-V, 30 (28%) V. The M survival was 1290 days (4-6715). In univariate analysis age (P<0.01), stage (p< 0.03), BMI (P 0.05) beta 2-microglobulin (p< 0.0001), Hgb (p<0.005), WBC (p<0.0004), BUN (p<0.0006), Cr (p<0.0002), LDH (p<0.0033,), second malignancy (P<0.0436) and V (p<0.04) were significant predictors of survival. In the multivariate analysis, B2-Microglobulin was the only significant independent predictor of survival (p < 0.0172). Comorbidity indices were not predictors of survival. Conclusions: Co morbidity indices were not able to able predict survival in this group as many patients were early stage pts with good performance status.