Charlson comorbidity index predicts poor outcome in CML patients treated with tyrosine kinase inhibitor

Abstract

Although the Sokal and Hasford scoring systems are well-known prognostic models specific to chronic myeloid leukemia (CML), whether they can effectively predict outcomes in elderly CML patients with comorbidities has not been fully elucidated. We evaluated the association between comorbidity at diagnosis with treatment outcome and survival in chronic phase CML patients. A questionnaire was administered to patients diagnosed with CML between 2001 and 2012 and treated with tyrosine kinase inhibitors (TKIs). The Charlson comorbidity index (CCI) was used to determine concomitant diseases. In total, 79 patients (33 females; median age, 57 years) were enrolled. CCI scores at diagnosis were between 2 and 11. At the last follow-up, 46 patients showed a major molecular response. Complete cytogenetic response was achieved in 73.4 % of the cases 12 months after TKI administration. We observed only five deaths during the 55.5-month median follow-up period. The risk categories (low/intermediate/high) associated with Sokal and Hasford scores were 33/27/7 and 21/43/3, respectively. The 27 cases with a CCI score >3 had significantly poorer survival after diagnosis (52 cases had a CCI score <2). CCI scores were inversely associated to overall survival. Concomitant comorbidity at diagnosis is associated with poor outcome in CML patients treated with TKIs.

Impact of the Charlson comorbidity index and prognostic nutritional index on prognosis in patients with early gastric cancer after endoscopic submucosal dissection

“…With regard to comorbidities, we evaluated CCI to predict the prognosis in patients with EGC after ESD. Based on ROC analysis and previous reports, we defined high‐risk comorbidities as having a CCI of ≥3 and low‐risk comorbidities as having a CCI of ≤2. Sekiguchi et al .…”

“…9,13 With regard to comorbidities, we evaluated CCI to predict the prognosis in patients with EGC after ESD. Based on ROC analysis and previous reports, 19,27 we defined high-risk comorbidities as having a CCI of ≥3 and low-risk comorbidities as having a CCI of ≤2. Sekiguchi et al 8 reported that PNI was a significant prognostic factor for patients aged ≥85 years who underwent ESD for EGC; however, CCI or PS was not a significant prognostic factor.…”

“…The Charlson comorbidity index (CCI) was developed to assess the risk of death from comorbidities . CCI has been widely used to evaluate clinical outcomes such as prognosis or complications . In addition, CCI has recently been used to assess the long‐term outcomes of endoscopic resection for EGC .…”

“…15 CCI has been widely used to evaluate clinical outcomes such as prognosis or complications. [16][17][18][19][20] In addition, CCI has recently been used to assess the long-term outcomes of endoscopic resection for EGC. 21,22 Prognostic nutritional index (PNI) was developed to assess the surgical risk for gastrointestinal tumors.…”

Cardiovascular Events throughout the Disease Course in Chronic Myeloid Leukaemia Patients Treated with Tyrosine Kinase Inhibitors—A Single-Centre Retrospective Study

“…Sokal, Hasford, and ELTS scores were assessed at the diagnosis time [ 25 ]. Age-adjusted risk of death estimation related to concomitant diseases was also carried out using the Charlson Comorbidity Index (CCI) [ 26 , 27 ].…”