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Comorbidities at Diagnosis: Predictive of Outcomes in CML?

By: Jenna Carter, PhD
Posted: Monday, September 28, 2020

An article published in Cancer Science reported on the prognostic effects of comorbid disorders in patients with chronic myeloid leukemia (CML) in the chronic phase. Research has shown that comorbidities in this patient population may affect overall survival despite the use of tyrosine kinase inhibitors, although the impact of second‐generation tyrosine kinase inhibitors is not well understood. Itaru Matsumura, MD, PhD, of Kindai University, Osaka-Sayama, Japan, and colleagues found that the overall survival rate was lower among patients with higher comorbidity scores.

"Our study demonstrated that the comorbidities at diagnosis were the only independent negative prognostic factor for overall survival in a population‐based cohort of patients with CML in chronic phase treated with imatinib or a second‐generation tyrosine kinase inhibitor," stated the investigators.

A total of 506 patients took part in the study, although only 452 (median age of 56) were evaluable for this analysis. The Charlson Comorbidity Index was used to assess survival rates in patients with CML in the chronic phase treated with imatinib (139) or a second‐generation tyrosine kinase inhibitor (nilotinib [169] and dasatinib [144]). Patients were stratified into groups based on their comorbidity index (2, 3, and ≥ 4), with a score of 4 or greater being considered strongly prognostic for overall survival.

A total of 99 patients had comorbidities, 72 patients with a score of and 27 patients with a score ≥ 4. The remaining 353 patients had a score of 2 on the comorbidity index. Although treatment responses did not seem to vary relative to the comorbidity score, the overall survival rate was significantly lower among patients with higher comorbidity scores, (P < .001). "Our results demonstrated that comorbidities at diagnosis were the most important predictive factor for successful treatment, regardless of the tyrosine kinase inhibitor type used in CML in chronic phase," concluded Dr. Matsumura and colleagues.

Disclosure: The study authors reported no conflicts of interest.



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