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      Relationship between co-morbidities at diagnosis, survival and ultimate cause of death in patients with chronic lymphocytic leukaemia (CLL): a prospective cohort study

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          Summary

          The ultimate cause of death for most patients with newly diagnosed chronic lymphocytic leukaemia (CLL) and its relationship to co-morbid health conditions is poorly defined. We conducted a prospective cohort study that systematically followed 1143 patients diagnosed with CLL between June 2002 and November 2014. Comorbid health conditions at the time of CLL diagnosis and their relationship to survival and cause of death were evaluated. Collectively, 1061 (93%) patients had at least one co-morbid health condition at the time of CLL diagnosis (median number 3). Despite this, 89% of patients had a low-intermediate Charlson Comorbidity Index score (CCI) at diagnosis. After a median follow-up of 6 years, 225 patients have died. Death was due to CLL progression in 85 (46%) patients, infection in 14 (8%) patients, other cancer in 35 (19%) patients and comorbid health conditions in 50 (27%) patients. Higher CCI score and a greater number of major comorbid health conditions at the time of CLL diagnosis was associated with shorter non-CLL specific survival, but not with shorter CLL-specific survival on multivariate analysis. In conclusion, CLL and CLL-related complications (infections and second cancers) are the overwhelming cause of death in patients with CLL, regardless of CCI score and number of comorbid health conditions at diagnosis.

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          Author and article information

          Journal
          0372544
          1822
          Br J Haematol
          Br. J. Haematol.
          British journal of haematology
          0007-1048
          1365-2141
          29 January 2019
          04 June 2017
          August 2017
          15 February 2019
          : 178
          : 3
          : 394-402
          Affiliations
          Mayo Clinic College of Medicine, Rochester, MN, USA
          Author notes

          Author contributions

          TDS designed the study, analysed the data, provided clinical care to patients and wrote the paper; PS designed the study, analysed data and wrote the paper; TGC, SAP and NEK provided clinical care to patients and co-authored the paper; KGC, SJA, JRC and SLS collected and analysed the data and co-authored the paper.

          Correspondence: Tait Shanafelt, MD, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. shanafelt.tait@ 123456mayo.edu
          Article
          PMC6377071 PMC6377071 6377071 nihpa1005561
          10.1111/bjh.14785
          6377071
          28580636
          55560900-13d7-46dd-b9d5-8fd020705a97
          History
          Categories
          Article

          chronic lymphocytic leukaemia,comorbidities,causes of death

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