在慢性淋巴细胞白血病患者的预后评估条件生存率
Pascal Schlosser1,2,3, Annett Schiwitza4, Jonas Klaus5
1Institute of Genetic Epidemiology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany.
Annals of hematology
|February 3, 2024
概括
条件生存分析显示,虽然慢性淋巴细胞白血病 (CLL) 的整体生存率稳定,但高风险患者的预后随着时间的推移而下降. 这凸显了在CLL管理中需要动态预后评估的需要.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 流行病学 流行病学
背景情况:
- 慢性淋巴细胞白血病 (CLL) 的预后生物标志物对于患者的评估至关重要.
- 在CLL中单点预后评估的长期有效性尚未得到充分证实.
- 条件生存 (CS) 研究,检查随时间推移的预后,在CLL中不常见,特别是在预后子组内.
研究的目的:
- 评估慢性淋巴细胞白血病 (CLL) 患者的条件生存 (CS) 并估计慢性淋巴细胞白血病 (CLL) 患者的1年递增的5年生存率.
- 评估 CLL 随着时间的推移,预后如何变化,考虑到基线疾病特征和风险因素.
- 确定基于CS的预后信息对CLL疾病管理和患者咨询的相关性.
主要方法:
- 条件生存 (CS) 分析对两个基于社区的CLL队列 (n=316和n=564) 进行了分析,这些队列在1984年至2021年之间被诊断出患有CLL.
- 估计的生存概率是按一年的增量计算,根据基线疾病特征和已知的风险因素分层.
- 分析的关键预后因素包括年龄,性别,疾病阶段,非突变IGHV,删除17p和CLL-IPI得分.
主要成果:
- 对于CLL患者的整体5年条件生存概率在10年期间保持稳定,约为75%.
- 年龄,性别和疾病阶段没有显著影响条件生存.
- 患有高风险特征 (非突变IGHV,del{17p},高CLL-IPI) 的患者在诊断时预后明显恶化,随着时间的推移,5年后的CS稳步下降.
结论:
- 随着时间的推移,CLL患者表现出稳定的生存概率,尽管持续过度死亡率.
- 高风险的CLL患者的预后随着每年的生存时间逐渐恶化.
- 条件生存提供了有价值的,动态的预后见解,对于有效的CLL管理和患者咨询至关重要.
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