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. 2022 May 12:12:885150.
doi: 10.3389/fonc.2022.885150. eCollection 2022.

Distinct Age-Related Clinical Features and Risk Assessment in Chinese With Chronic Lymphocytic Leukemia

Zheng Tian  1   2   3   4   5   6 , Ming Liu  2   4   5   6 , Xiaosheng Fang  1   2   3   4   5   6 , Xiangxiang Zhou  1   2   3   4   5   6 , Peipei Li  1   2   3   4   5   6 , Ying Li  1   2   3   4   5   6 , Lingyan Zhang  1   2   3   4   5   6 , Fang Liu  7 , Ya Zhang  2   4   5   6 , Xin Wang  1   2   3   4   5   6
Affiliations

Distinct Age-Related Clinical Features and Risk Assessment in Chinese With Chronic Lymphocytic Leukemia

Zheng Tian et al. Front Oncol. .

Abstract

The biological and clinical features of chronic lymphocytic leukemia (CLL) exhibited profound heterogeneity across Chinese and patients of predominately European descent. However, the age-related peculiarities and risk assessment of Chinese CLL patients remained ill-defined. The present study demonstrated that CLL patients were characterized by the earlier age at onset in China (median age at diagnosis: 63 years old) than in the United States (median age at diagnosis: 69 years old). Young patients from Shandong Provincial Hospital CLL database displayed prolonged overall survival than the Surveillance, Epidemiology, and End Results cohort. Furthermore, among Chinese CLL patients, young patients showed an increased relapse rate compared with elderly patients. To optimize the risk assessment of CLL patients, novel risk score models named PR-Score and HBG-Score were developed for predicting the outcomes of young and elderly CLL patients respectively. The neonatal survival prediction systems were superior to international prognostic index for CLL (CLL-IPI) and Binet stage in assessing the overall survival and progression free survival of CLL patients. The analyses highlighted refinement of risk evaluation for CLL patients in different age groups, providing insights into individualized diagnosis and treatment of CLL.

Keywords: age; chronic lymphocytic leukemia; prognosis; real world observation; risk score.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Age composition of CLL patients. (A) Age composition of Chinese patients with chronic lymphocytic leukemia (CLL) included in the Shandong Provincial Hospital CLL (SPHCLL) database from 2010 to 2021. (B) Age composition of CLL patients of predominately European descent registered in the Surveillance, Epidemiology, and End Results (SEER) database from 2010 to 2018. (C) Age composition of Asian Americans with CLL registered in the SEER database from 2010 to 2018. (D) Age composition ratio of CLL patients after standardization according to the age distributions of the United States (US) and China.
Figure 2
Figure 2
Survival analysis among CLL patients from the US and China. (A) Overall survival (OS) differences among patients from the SEER database and the Chinese SPHCLL database. (B) OS differences among young (<60 years old) patients from the SEER database and the Chinese SPHCLL database.
Figure 3
Figure 3
Survival analysis of Chinese CLL patients. (A) OS differences among young (<60 years old) and elderly (≥60 years old) Chinese CLL patients from the SPHCLL database. (B) Progression free survival (PFS) differences among young and elderly Chinese CLL patients from the SPHCLL database.
Figure 4
Figure 4
Novel risk score models for young (<60 years old) and elderly (≥60 years old) CLL patients. (A) Increased PR-Score significantly correlated with shortened OS in young patients. (B) Increased PR-Score significantly correlated with shortened PFS in young patients. (C) PR-Score model showed advanced prognostic ability than international prognostic index for CLL (CLL-IPI) and Binet stage in predicting OS of young patients. (D) PR-Score model showed advanced prognostic ability than CLL-IPI and Binet stage in predicting PFS of young patients. (E) Increased HBG-Score significantly correlated with shortened OS in elderly patients. (F) Increased HBG-Score significantly correlated with shortened PFS in elderly patients. (G) HBG-Score model showed advanced prognostic ability than CLL-IPI and Binet stage in predicting OS of elderly patients. (H) HBG-Score model showed advanced prognostic ability than CLL-IPI and Binet stage in predicting PFS of elderly patients.
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