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Jeremy S. Abramson, MD, MMSc
Jeremy S. Abramson, MD, MMSc
Posted: Monday, February 24, 2025
According to Roberta Santos Azevedo, MD, PhD, of Dana-Farber Cancer Institute, Boston, and colleagues, the introduction of targeted therapy has improved chronic lymphocytic leukemia (CLL) survival rates, although patients diagnosed within the past decade may not benefit from chemoimmunotherapy-era prognostic models. These investigators aimed to evaluate overall survival and the impact of prognostic factors over the past decade, and their results were presented during the 2024 American Society of Hematology (ASH) Annual Meeting & Exposition (Abstract 583).
“Despite improvements in outcomes with targeted therapy, high- and very high–risk CLL-International Prognostic Index (IPI) patients still experience worse overall survival,” the authors concluded. “New therapeutic strategies targeting high- and very high–risk CLL are necessary to improve outcomes for nearly one-third of CLL patients.”
This retrospective study analyzed the data of 1,339 patients with CLL from the Dana-Farber Cancer Institute CLL database. Overall survival from diagnosis to death was recorded for each patient; survival probability was estimated using Kaplan-Meier curves, and the impact of prognostic factors on overall survival was evaluated using Cox proportional hazards models.
The median follow-up was 58 months, and the 5-year overall survival rate was 94.3%. Infections, second cancer, disease progression, and cardiovascular disease were the most common causes of death. Patients who had high- and very high–risk CLL had significantly higher mortality rates than those with low- and intermediate-risk disease. The 5-year overall survival rate was highest among patients with intermediate-risk (98.9%) disease, followed by low- (96.3%), high- (92.2%), and very high–risk (87.8%) disease.
Univariate analysis revealed that CLL-IPI factors such as beta-2 microglobulin over 3.5 mg/dL (P < .001), Rai stage I to IV (P = .03), TP53 aberration (P < .001), unmutated IGHV (P = .001), and age older than 65 (P < .001) were significantly associated with overall survival. Of note, ZAP-70 expression (P = .003) and a complex karyotype (P < .001) correlated with inferior overall survival.
Disclosure: Dr. Azevedo reported no conflicts of interest. For full disclosures of the other study authors, visit ash.confex.com.
2024 ASH Annual Meeting & Exposition
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