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. 2024 Nov 12;8(11):e70015.
doi: 10.1002/hem3.70015. eCollection 2024 Nov.

Causes of death among patients diagnosed with chronic lymphocytic leukemia: A population-based study in the Netherlands, 1996-2020

Lina van der Straten  1   2   3 , Mark-David Levin  2 , Manette A W Dinnessen  1 , Otto Visser  4 , Eduardus F M Posthuma  5   6 , Jeanette K Doorduijn  7 , Anton W Langerak  3 , Arnon P Kater  8 , Avinash G Dinmohamed  1   8   9   10
Affiliations

Causes of death among patients diagnosed with chronic lymphocytic leukemia: A population-based study in the Netherlands, 1996-2020

Lina van der Straten et al. Hemasphere. .

Abstract

Chronic lymphocytic leukemia (CLL) manifests heterogeneously with varying outcomes. This population-based study examined causes of death (CODs), as registered by the physician who established the death, among 20,588 CLL patients diagnosed in the Netherlands between 1996 and 2020. Utilizing cause-specific flexible parametric survival models, we estimated cause-specific hazard ratios (HRs) and cumulative incidences of death due to CLL, solid malignancies, other hematological malignancies, infections, and other causes. Our findings reveal CLL as the predominant COD, contributing to around 40% of relative mortality, with a declining 5-year death probability from 16.8% in 1996-2002 to 7.6% in 2010-2020. Also, deaths attributed to solid malignancies, other hematological malignancies, and other COD diminished over time, as evidenced by respective HRs (95% confidence interval) of 0.68 (0.60%-0.77%), 0.45 (0.38%-0.53%), and 0.77 (0.66%-0.90%). In summary, our comprehensive, population-based analysis underscores a noticeable reduction in CLL-attributed deaths and other competing causes over the studied period. Nonetheless, CLL is registered as the most prevalent cause of mortality among contemporary diagnosed patients with CLL, emphasizing the continued relevance of CLL-centric clinical strategies and research.

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Conflict of interest statement

Arnon P. Kater has received personal fees from AbbVie, LAVA, Genmab, Janssen, AstraZeneca, Roche/Genentech, and Bristol Myers Squibb; and research funding from AbbVie, Janssen, AstraZeneca, Roche/Genentech, and Bristol Myers Squibb. Mark‐David Levin has received personal fees from AbbVie, Janssen, and Roche; and research funding from AbbVie, Janssen, AstraZeneca, and Roche/Genentech. Anton W. Langerak has received research funding via an unrestricted grant from Roche‐Genentech and speaker fees from Janssen. The remaining authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Cumulative incidences, with associated 95% confidence intervals, of chronic lymphocytic leukemia‐related death, death due to other hematological malignancies, death due to solid malignancies, death due to infections, and death due to other causes of patients with chronic lymphocytic leukemia according to the years since diagnosis, stratified according to sex and age categories.
Figure 2
Figure 2
Five‐year cumulative incidence of chronic lymphocytic leukemia‐related death over time, stratified according to sex and age categories.
Figure 3
Figure 3
Stacked 5‐year cumulative incidence of chronic lymphocytic leukemia‐related death, death due to other hematological malignancies, death due to solid malignancies, death due to infections, and death due to other causes over time, stratified according to sex and age categories.
Figure 4
Figure 4
Stacked 5‐year cumulative incidence of chronic lymphocytic leukemia‐related death, death due to other hematological malignancies, death due to solid malignancies, death due to infections, and death due to other causes over time, stratified according to Rai disease stage at diagnosis.
See this image and copyright information in PMC

References

    1. Dores GM, Anderson WF, Curtis RE, et al. Chronic lymphocytic leukaemia and small lymphocytic lymphoma: overview of the descriptive epidemiology. Br J Haematol. 2007;139(5):809‐819. - PubMed
    1. Smith A, Howell D, Patmore R, Jack A, Roman E. Incidence of haematological malignancy by sub‐type: a report from the Haematological Malignancy Research Network. Br J Cancer. 2011;105(11):1684‐1692. - PMC - PubMed
    1. Hallek M, Cheson BD, Catovsky D, et al. Guidelines for the diagnosis and treatment of chronic lymphocytic leukemia: a report from the International Workshop on Chronic Lymphocytic Leukemia updating the National Cancer Institute–Working Group 1996 guidelines. Blood. 2008;111(12):5446‐5456. - PMC - PubMed
    1. Strati P, Parikh SA, Chaffee KG, et al. Relationship between co‐morbidities at diagnosis, survival and ultimate cause of death in patients with chronic lymphocytic leukaemia (CLL): a prospective cohort study. Br J Haematol. 2017;178(3):394‐402. - PMC - PubMed
    1. Steingrímsson V, Lund SH, Dickman PW, et al. Survival, causes of death, and the prognostic role of comorbidities in chronic lymphocytic leukemia in the pre‐ibrutinib era: a population‐based study. Eur J Haematol. 2022;108(2):145‐153. - PubMed

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