BACKGROUND: Clinical management of chronic lymphocytic leukemia patients has changed considerably over the last years, reflected in an increased use of prognostic markers, new therapeutic agents and procedures, and supportive care measures. However, to date, clinical trials have not shown a survival benefit. DESIGN AND METHODS: Using population-based data from Sweden, we assessed variations in survival among all chronic lymphocytic leukemia patients (n=11,179) reported from 1973-2003. Relative survival ratios were computed as measures of patient survival. RESULTS: Overall we found significantly improved (p<0.0001) 5-, 10-, and 20-year relative survival ratio for the entire cohort during the study period. Improved 5- and 10-year relative survival ratio was found for all age-groups (p<0.0001) and both sexes. Compared to females, however, males had a significantly inferior survival in all age groups and calendar periods (p<0.0001). Younger chronic lymphocytic leukemia patients had a superior survival compared to older chronic lymphocytic leukemia patients, in all calendar periods (p<0.0001). Five-year relative survival ratio has not improved in the youngest chronic lymphocytic leukemia patients since the 1980s; however, older patients have had a continuous improvement in 5 year-relative survival ratio. CONCLUSIONS: The observed improvements are likely due to improved therapeutic developments and supportive care. Our findings suggest that elderly chronic lymphocytic leukemia patients might benefit more from the recently introduced drugs in chronic lymphocytic leukemia. Future clinical trials are needed to better define underlying mechanisms of observed heterogeneity in chronic lymphocytic leukemia survival by age and sex, and evaluate the role of newer chronic lymphocytic leukemia therapy in the elderly.
BACKGROUND: Clinical management of chronic lymphocytic leukemiapatients has changed considerably over the last years, reflected in an increased use of prognostic markers, new therapeutic agents and procedures, and supportive care measures. However, to date, clinical trials have not shown a survival benefit. DESIGN AND METHODS: Using population-based data from Sweden, we assessed variations in survival among all chronic lymphocytic leukemiapatients (n=11,179) reported from 1973-2003. Relative survival ratios were computed as measures of patient survival. RESULTS: Overall we found significantly improved (p<0.0001) 5-, 10-, and 20-year relative survival ratio for the entire cohort during the study period. Improved 5- and 10-year relative survival ratio was found for all age-groups (p<0.0001) and both sexes. Compared to females, however, males had a significantly inferior survival in all age groups and calendar periods (p<0.0001). Younger chronic lymphocytic leukemiapatients had a superior survival compared to older chronic lymphocytic leukemiapatients, in all calendar periods (p<0.0001). Five-year relative survival ratio has not improved in the youngest chronic lymphocytic leukemiapatients since the 1980s; however, older patients have had a continuous improvement in 5 year-relative survival ratio. CONCLUSIONS: The observed improvements are likely due to improved therapeutic developments and supportive care. Our findings suggest that elderly chronic lymphocytic leukemiapatients might benefit more from the recently introduced drugs in chronic lymphocytic leukemia. Future clinical trials are needed to better define underlying mechanisms of observed heterogeneity in chronic lymphocytic leukemia survival by age and sex, and evaluate the role of newer chronic lymphocytic leukemia therapy in the elderly.
Authors: S M O'Brien; H M Kantarjian; J Cortes; M Beran; C A Koller; F J Giles; S Lerner; M Keating Journal: J Clin Oncol Date: 2001-03-01 Impact factor: 44.544
Authors: J C Byrd; T Murphy; R S Howard; M S Lucas; A Goodrich; K Park; M Pearson; J K Waselenko; G Ling; M R Grever; A J Grillo-Lopez; J Rosenberg; L Kunkel; I W Flinn Journal: J Clin Oncol Date: 2001-04-15 Impact factor: 44.544
Authors: K R Rai; B L Peterson; F R Appelbaum; J Kolitz; L Elias; L Shepherd; J Hines; G A Threatte; R A Larson; B D Cheson; C A Schiffer Journal: N Engl J Med Date: 2000-12-14 Impact factor: 91.245
Authors: M Leporrier; S Chevret; B Cazin; N Boudjerra; P Feugier; B Desablens; M J Rapp; J Jaubert; C Autrand; M Divine; B Dreyfus; K Maloum; P Travade; G Dighiero; J L Binet; C Chastang Journal: Blood Date: 2001-10-15 Impact factor: 22.113
Authors: K Ideström; E Kimby; M Björkholm; H Mellstedt; L Engstedt; G Gahrton; B Johansson; D Killander; K H Robérts; A M Stalfelt; A M Udén; B Wadman; S Wählby Journal: Eur J Cancer Clin Oncol Date: 1982-11
Authors: Sigurdur Y Kristinsson; Sandra Eloranta; Paul W Dickman; Therese M-L Andersson; Ingemar Turesson; Ola Landgren; Magnus Björkholm Journal: Am J Hematol Date: 2012-11-19 Impact factor: 10.047
Authors: Magnus Björkholm; Lotta Ohm; Sandra Eloranta; Asa Derolf; Malin Hultcrantz; Jan Sjöberg; Therese Andersson; Martin Höglund; Johan Richter; Ola Landgren; Sigurdur Y Kristinsson; Paul W Dickman Journal: J Clin Oncol Date: 2011-05-16 Impact factor: 44.544
Authors: Tait D Shanafelt; Kari G Rabe; Neil E Kay; Clive S Zent; Diane F Jelinek; Megan S Reinalda; Susan M Schwager; Debbie A Bowen; Susan L Slager; Curtis A Hanson; Timothy G Call Journal: Cancer Date: 2010-10-15 Impact factor: 6.860
Authors: Neda Alrawashdh; Joann Sweasy; Brian Erstad; Ali McBride; Daniel O Persky; Ivo Abraham Journal: Ann Hematol Date: 2021-07-19 Impact factor: 3.673
Authors: Mark D Danese; Robert I Griffiths; Michelle Gleeson; Sacha Satram-Hoang; Kevin Knopf; Joseph Mikhael; Carolina Reyes Journal: Blood Date: 2010-12-29 Impact factor: 22.113