Ethnic and geographic diversity of chronic lymphocytic leukaemia

Yang, Shenmiao; Varghese, Abraham; Sood, Nitin; Chiattone, Carlos S.; Akinola, N. O.; Huang, Xiao‐Jun; Gale, Robert Peter

doi:10.1038/s41375-020-01057-5

Cited by 31 publications

(35 citation statements)

References 47 publications

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“…These genetic differences may underlie different etiological, pathogenetic, and biological features of CLL between Asians and persons of predominantly European descent with CLL and explain the regional difference of CLL’s incidence partly. All populations arose from a common African Black ancestor, but different clades have different admixture with archaic hominins including Neanderthals, Denisovans, and Homo erectus , which may explain different CLL incidences ( 5 ).…”

Section: Discussionmentioning

confidence: 99%

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Trends in Disease Burden of Chronic Lymphocytic Leukemia at the Global, Regional, and National Levels From 1990 to 2019, and Projections Until 2030: A Population-Based Epidemiologic Study

Long

et al. 2022

Front. Oncol.

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BackgroundThe prognosis of chronic lymphocytic leukemia (CLL) has been improved dramatically, but there are limited studies focusing on CLL disease burden on a global scale. We aimed to evaluate the accurate assessment of the disease burden of CLL that may provide more detailed epidemiological information for rational policies.MethodsThe main source of the data was the Global Burden of Disease (GBD) study 2019. Incident cases, death cases, disability-adjusted life years (DALYs), and their corresponding age-standardized rates (ASRs) from 1990 to 2019 were used to describe the burden of CLL. Data about attributable risk factors were also extracted and analyzed. Bayesian age-period-cohort (BAPC) models were used to assess and project the incidence and mortality rates till 2030.ResultsGlobally, the incidence of CLL had been increasing. Deaths and DALYs decreased slightly. The burden of death and DALY is affected by socio-demographic index (SDI). The incidence rate, death rate, and DALY rate of CLL increased significantly with age. Male-to-female ratios of incidence rates varied in different SDI quintiles. Smoking, high body mass index, and occupational exposure to benzene or formaldehyde were the potential risk factors related to CLL. Global ASIRs might tend to increase until 2030, while ASDR would decrease until 2030.ConclusionThe disease burden of CLL decreased in higher SDI countries but increased in lower ones. Strategies for early detection of asymptomatic CLL, development of novel drugs, and measures against attributable factors should be implemented to combat CLL burden.

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Section: Discussionmentioning

confidence: 99%

“…It is considered to be a disease of older adults, with a median age of approximately 70 years at diagnosis ( 3 ). The incidence of CLL varies by race and geographic location, which is higher among Caucasians ( 2 , 4 ) and extremely low in Asia ( 5 , 6 ).…”

Section: Introductionmentioning

confidence: 99%

Trends in Disease Burden of Chronic Lymphocytic Leukemia at the Global, Regional, and National Levels From 1990 to 2019, and Projections Until 2030: A Population-Based Epidemiologic Study

Long

et al. 2022

Front. Oncol.

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“… 6 Here, we added a German cohort. CLL is influenced by genetic factors which is reflected by the facts that (i) CLL occurs mainly in Western populations and is rarely seen in Asians, 11 and (ii) the risk of first degree relatives is increased by approximately 7-fold. 12 Although, environmental factors, like infections and nutrition are presumably involved in disease etiology, the low incidence in Asians is most likely not due to environmental factors since also Asians living in the USA have a low incidence in developing CLL.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a Prognostic Epigenetic Classification System in Chronic Lymphocytic Leukemia Patients

et al. 2022

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Background: Methylation at 5 CpG sites was previously shown to classify chronic lymphocytic leukemia (CLL) into 3 prognostic subgroups. Here, we aimed to validate the marker set in an additional cohort and to evaluate its clinical utility for CLL patient stratification. Methods: We evaluated this epigenetic marker set in 79 German patients using bisulfite treatment followed by pyrosequencing and classification using a support vector machine-learning tool. Results: The n-CLL, i-CLL, and m-CLL classification was detected in 28 (35%), 10 (13%), and 41 (51%) patients, respectively. Epigenetic grouping was associated with IGHV mutational status ( P = 2 × 10−12), isolated del13q ( P = 9 × 10−6), del17p ( P = .015), complex karyotype ( P = .005), VH-usage, and clinical outcome as time to first treatment ( P = 1.4 × 10−12) and overall survival ( P = .003). Multivariate Cox regression analysis identified n-CLL as a factor for earlier treatment hazard ratio (HR), 6.3 (95% confidence interval [CI] 2.4-16.4; P = .0002) compared to IGHV mutational status (HR 4.6, 95% CI 1.9-11.3, P = .0008). In addition, when comparing the prognostic value of the epigenetic classification system with the IGHV classification, epigenetic grouping performed better compared to IGHV mutational status using Kaplan-Meier estimation and allowed the identification of a third, intermediate (i-CLL) group. Thus, our study confirmed the prognostic value of the epigenetic marker set for patient stratification in routine clinical diagnostics.

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“…The incidence of CLL constantly increases with age, and the median age at onset of CLL was between 67 and 72 years old in the United States (US) ( 14 , 15 ). Because of improved quality of life and advanced medical technology, the proportion of young CLL patients with early symptoms is increasing.…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, Asians with CLL are featured by the earlier age at onset compared with persons of predominately European descent. The median age at diagnosis of CLL ranged from 58 to 62 years old in China, and the median age at diagnosis of Chinese CLL patients included in this study was 63 years old ( 14 ). Moreover, the present study revealed the different survival profiles of young CLL patients between China and Western countries.…”

Section: Introductionmentioning

confidence: 99%

Distinct Age-Related Clinical Features and Risk Assessment in Chinese With Chronic Lymphocytic Leukemia

et al. 2022

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The biological and clinical features of chronic lymphocytic leukemia (CLL) exhibited profound heterogeneity across Chinese and patients of predominately European descent. However, the age-related peculiarities and risk assessment of Chinese CLL patients remained ill-defined. The present study demonstrated that CLL patients were characterized by the earlier age at onset in China (median age at diagnosis: 63 years old) than in the United States (median age at diagnosis: 69 years old). Young patients from Shandong Provincial Hospital CLL database displayed prolonged overall survival than the Surveillance, Epidemiology, and End Results cohort. Furthermore, among Chinese CLL patients, young patients showed an increased relapse rate compared with elderly patients. To optimize the risk assessment of CLL patients, novel risk score models named PR-Score and HBG-Score were developed for predicting the outcomes of young and elderly CLL patients respectively. The neonatal survival prediction systems were superior to international prognostic index for CLL (CLL-IPI) and Binet stage in assessing the overall survival and progression free survival of CLL patients. The analyses highlighted refinement of risk evaluation for CLL patients in different age groups, providing insights into individualized diagnosis and treatment of CLL.

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Ethnic and geographic diversity of chronic lymphocytic leukaemia

Cited by 31 publications

References 47 publications

Trends in Disease Burden of Chronic Lymphocytic Leukemia at the Global, Regional, and National Levels From 1990 to 2019, and Projections Until 2030: A Population-Based Epidemiologic Study

Trends in Disease Burden of Chronic Lymphocytic Leukemia at the Global, Regional, and National Levels From 1990 to 2019, and Projections Until 2030: A Population-Based Epidemiologic Study

Evaluation of a Prognostic Epigenetic Classification System in Chronic Lymphocytic Leukemia Patients

Distinct Age-Related Clinical Features and Risk Assessment in Chinese With Chronic Lymphocytic Leukemia

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