Impact of comorbidities on overall survival in patients with chronic myeloid leukemia: results of the randomized CML study IV.

Saussele, Susanne; Krauss, Marie-Paloma; Hehlmann, Rüdiger; Lauseker, Michael; Proetel, Ulrike; Kalmanti, Lida; Hanfstein, Benjamin; Fabarius, Alice; Kraemer, Doris; Berdel, Wolfgang E; Bentz, Martin; Staib, Peter; de Wit, Maike; Wernli, Martin; Zettl, Florian; Hebart, Holger F; Hahn, Markus; Heymanns, Jochen; Schmidt-Wolf, Ingo; Schmitz, Norbert; ... (2015). Impact of comorbidities on overall survival in patients with chronic myeloid leukemia: results of the randomized CML study IV. Blood, 126(1), pp. 42-49. American Society of Hematology 10.1182/blood-2015-01-617993

[img] Text
EO_42.full.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (1MB) | Request a copy

We studied the influence of comorbidities on remission rate and overall survival (OS) in patients with chronic myeloid leukemia (CML). Participants of the CML Study IV, a randomized 5-arm trial designed to optimize imatinib therapy, were analyzed for comorbidities at diagnosis using the Charlson Comorbidity Index (CCI); 511 indexed comorbidities were reported in 1519 CML patients. Age was an additional risk factor in 863 patients. Resulting CCI scores were as follows: CCI 2, n = 589; CCI 3 or 4, n = 599; CCI 5 or 6, n = 229; and CCI ≥ 7, n = 102. No differences in cumulative incidences of accelerated phase, blast crisis, or remission rates were observed between patients in the different CCI groups. Higher CCI was significantly associated with lower OS probabilities. The 8-year OS probabilities were 93.6%, 89.4%, 77.6%, and 46.4% for patients with CCI 2, 3 to 4, 5 to 6, and ≥7, respectively. In multivariate analysis, CCI was the most powerful predictor of OS, which was still valid after removal of its age-related components. Comorbidities have no impact on treatment success but do have a negative effect on OS, indicating that survival of patients with CML is determined more by comorbidities than by CML itself. OS may therefore be inappropriate as an outcome measure for specific CML treatments. The trial was registered at www.clinicaltrials.gov as #NCT00055874.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Haematology and Central Haematological Laboratory
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > Unit Childrens Hospital > Forschungsgruppe Hämatologie (Erwachsene)

UniBE Contributor:

Oppliger Leibundgut, Elisabeth

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0006-4971

Publisher:

American Society of Hematology

Language:

English

Submitter:

Verena Zwahlen

Date Deposited:

24 Mar 2016 13:32

Last Modified:

24 Mar 2016 13:32

Publisher DOI:

10.1182/blood-2015-01-617993

PubMed ID:

25918346

BORIS DOI:

10.7892/boris.78720

URI:

https://boris.unibe.ch/id/eprint/78720

Actions (login required)

Edit item Edit item
Provide Feedback