COMORBIDITY & CLL DIFFERENT SCORES – DIFFERENT RESULTS

Abstract

Introduction: Due to the implementation of the outpatient centres, our network provides care for 50% of the patients with hematological diseases in Vienna. Here we analyse the influence of our own CIRS Score on survival of CLL patients. Additionally we focus on renal comorbidities. Methods: 1150 CLL patients who were diagnosed, observed and treated between 2011 and 2021 within our haematological network were analysed. Study data was generated by reviewing electronic and paper medical records. Comorbidities were assessed with the conventional CIRS Score including utilizing our own Version where we did not focus on severity to detect more patients. We differentiated between 2 groups: low risk pts. without any or with just one existing co-morbidity and high-risk patients with 2 or more organ systems involved, regardless of the severity. Moreover we demonstrate a Composite Comorbidity Score “Severe4” with <3 or >3 points, validated in 4 Organ Systems as shown on ASH 2022 by Shouse et al. and the cut-off Score of 6 points as used by the German CLL Study Group. Furthermore the Cockcroft-Gault formula (GFR). Results: 55% of the patients were male. The median age at diagnosis was 68 years. IGHV was mutated in 53% of patients, del(17p) was present in 7,4% of patients. 27% of our 1150 patients received CLL specific treatment. As shown in Figure 1 our own interpretation of the CIRS-Score was able to identify 625 pts. classified as high risk with a significant lower OS. Regardless of the Severity, the involvement of 2 or more organ systems was more relevant than just one. Similarly to the Severe4 Score we could also show a significant OS difference in 167 pts. using a cut-off Score of 3 Points in at least one category. A highly significant OS difference can also be shown in 245 pts when using the established cut-off Score of 6 points. Emphasizing the weakness of the CIRS Score in detecting renal comorbidity due to the high threshold concerning the Serum Creatinine of 1,5 mg/dl we were able to demonstrate that 144 of our pts. had a GFR of <60 mL/min at time of diagnosis, which reflects Stage 3 CKD, resulting in a significant lower OS. When using the CIRS Score alone only 31 pts. would have been classified as renal impaired. Keyword: chronic lymphocytic leukemia (CLL) No conflicts of interests pertinent to the abstract.