Improved survival in chronic lymphocytic leukemia in the past decade: a population-based study including 11,179 patients diagnosed between 1973-2003 in Sweden

Kristinsson, Sigurður Y.; Dickman, Paul W.; Wilson, Wyndham H.; Caporaso, Neil; Björkholm, Magnus; Landgren, Ola

doi:10.3324/haematol.2009.007849

Cited by 73 publications

(79 citation statements)

References 28 publications

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“…Similar observations have been made in other hematologic malignancies, but the underlying mechanisms are unknown [36,38]. Possible explanations to this finding are different clinical stage at diagnosis, co-morbidity, and different distribution of prognostic factors among males and females.…”

Section: Discussionsupporting

confidence: 66%

Patterns of survival in lymphoplasmacytic lymphoma/waldenström macroglobulinemia: A population‐based study of 1,555 patients diagnosed in Sweden from 1980 to 2005

et al. 2012

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1980-1985, 1986-1990, 1991-1995, 1996-2000, and 2001-2005, respectively. Improvement in 1-and 5-year relative survival was found in all age groups and for LPL and WM separately. Patients with WM had lower excess mortality compared to LPL (EMRR 5 0.38; 95% CI 0.30-0.48). Older age at diagnosis was associated with a poorer survival (P < 0.001). Taken together, we found a significant improvement in survival in LPL/WM over time. Despite this progress, new effective agents with a more favourable toxicity profile are needed to further improve survival in LPL/ WM, especially in the elderly. Am. J. Hematol. 88:60-65, 2013. V

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Section: Discussionsupporting

confidence: 66%

Patterns of survival in lymphoplasmacytic lymphoma/waldenström macroglobulinemia: A population‐based study of 1,555 patients diagnosed in Sweden from 1980 to 2005

et al. 2012

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“…This is shown by the consistently better overall survival in our four randomized trials and in our registration control series of early CLL, as well as in large population-based studies. 3,4 Further support for this finding is seen in women's longer progression-free survival, shown here in our LRF CLL4 trial and also in an Italian series of patients with Binet stage A CLL. 5 In addition, we report that women had a better overall response to treatment than men (Table 2) and greater gastro-intestinal toxicity.…”

Section: Discussionsupporting

confidence: 61%

“…[2][3][4][5] We have identified three possible factors which may contribute to the better treatment response and longer survival in women. Firstly, the association with good prognostic factors; secondly, pharmacokinetic differences between the sexes; and thirdly the effect of estrogens.…”

Section: Discussionmentioning

confidence: 99%

“…Large population-based studies from Sweden 3 and the United States 4 subsequently confirmed the difference in overall survival between the sexes. Kristinsson et al 3 documented a statistically significant inferior survival for men compared to women in all age groups and calendar periods in their 30-year study of patients with CLL. The updated SEER-18 Registry 4 also showed that women had a significantly better overall survival than men when the whole CLL population was evaluated and across different age groups, including when CLL-specific causes of death were considered separately.…”

Section: Introductionmentioning

confidence: 99%

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The clinical significance of patients' sex in chronic lymphocytic leukemia

Catovsky¹,

Wade

Else³

2014

Haematologica

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© F e r r a t a S t o r t i F o u n d a t i o nwhere. 2,9,10 Briefly, chlorambucil was one of the arms in every trial. 11The comparators were the combination of COP (cyclophosphamide, oncovin and prednisolone) and splenic irradiation in CLL1, chlorambucil plus prednisolone and splenic irradiation in CLL2, chlorambucil plus epirubicin in CLL3, and fludarabine with or without cyclophosphamide in LRF CLL4. Biological, cytogenetic and molecular markers were available from patients entered in the LRF CLL4 trial and have been reported elsewhere, together with a full description of the cutoffs used to define positivity. 12,13 Causes of death were centrally categorized using the patients' death certificates and/or reports from the participating centers. Follow-up (overall survival only) was to June 2012 for the trials and June 2010 for the registration series, with a median follow-up for each trial of at least 9 years.Statistical analyses used the chi square test for comparisons of incidence, response to therapy and toxicities. Kaplan-Meier survival curves were calculated and compared by the log-rank test. Overall survival was calculated from randomization to death from any cause. Progression-free survival in the LRF CLL4 trial was defined as the time from randomization to relapse needing further treatment, progression, or death from any cause. For non-responders and progressive disease, date of progression was when no response or progressive disease was recorded. Multivariate analyses of variables significantly associated with response and overall survival in univariate tests were performed by means of stepwise generalized linear modeling and the Cox proportional hazards model respectively. Values of P≤0.05 (two sided) were considered statistically significant. Analyses were performed using the STA-TISTICA software from StatSoft, a wholly owned subsidiary of Dell, Inc.The LRF CLL4 trial was registered as an International Standard Randomized Trial, number ISRCTN58585610 and was approved by the UK multicenter research ethics committee (MREC). All four trials followed the UK Medical Research Council guidelines for good clinical practice. All patients provided informed consent. All authors had access to the primary clinical trial data. The main trial endpoints have been previously reported. 2,9,10 ResultsThe main characteristics of the patients in both series are shown in Table 1. The proportion of females was significantly higher in the registration series than in the randomized series. Women were more likely than men to be aged ≥70 years in both series. They were more likely to have Binet stage A-progressive disease than stage B or C in the randomized series and slightly more likely to have Rai stage 0 disease than Rai stages I-II in the registration series.Overall survival was significantly longer in women both in the randomized series [hazard ratio (HR): 0.72, 95% confidence interval (CI): 0.64-0.81, P<0.0001; Figure 2A Figure 2B). At 10 years, the overall survival rate in the randomized series was 27% (95% CI...

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“…Tıbbi tedavide tekli protokoller (fludarabin) ya da kombinasyon protokolleri (glukokortikoidler, akilleyici ajanlar, pürin analogları gibi) uygulanmaktadır. (5,6) KLL hastaları-nın % 25'inde tanı sırasında herhangi bir semptom bulunmaz. Tanı genellikle başka bir patoloji için kan testleri yapılırken konur.…”

Section: Olgu Sunumuunclassified

A Chronic Lymphocytic Leukaemia Case: Accepted and Treated with an Initial Diagnosis of Crimean-Congo Hemorrhagic Fever

Elci¹,

Talay²,

Arslan³

et al. 2012

J Turk Anaesth Int Care

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Improved survival in chronic lymphocytic leukemia in the past decade: a population-based study including 11,179 patients diagnosed between 1973-2003 in Sweden

Cited by 73 publications

References 28 publications

Patterns of survival in lymphoplasmacytic lymphoma/waldenström macroglobulinemia: A population‐based study of 1,555 patients diagnosed in Sweden from 1980 to 2005

Patterns of survival in lymphoplasmacytic lymphoma/waldenström macroglobulinemia: A population‐based study of 1,555 patients diagnosed in Sweden from 1980 to 2005

The clinical significance of patients' sex in chronic lymphocytic leukemia

A Chronic Lymphocytic Leukaemia Case: Accepted and Treated with an Initial Diagnosis of Crimean-Congo Hemorrhagic Fever

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