Significance of comorbidity for patients with chronic lymphocytic leukemia

Abstract

Background: Chronic lymphocytic leukemia (CLL) remains an uncurable disease, in which the age, number and severity of comorbidities primarily determine the choice of therapeutic tactics and objectives. Aim:P To evaluate actual comorbidity and polymorbidity in patients with CLL and a possible relationship between the diseases and comorbidities that are considered concurrent and side effects of the administered treatment. Materials and methods: The study consisted of two parts. In a retrospective study, we analyzed records of patients with CLL from the Registry for Diagnostics and Treatment of Lymphoproliferative Diseases. In addition, we thoroughly evaluated and prospectively followed up 124 patients in the course of their preparation to a new stage of CLL tratement. Results: Examining data from the Russian Registry for Diagnostics and Treatment of Lymphoproliferative Diseases (n=1361) showed that in Russia, the age of patients with newly diagnosed CLL has increased in the recent decade with the increase in life span, which might change the comorbidity structure. Comparing retrospective and our own data (n=124) showed that diagnoses of concurrent diseases are often recorded formally (p<0.0001). This suggests a need for thorough evaluation of CLL patients by therapists and cardiologists. In this study, where the cardiological and therapeutic status of CLL patients was assessed adequately, the computed Charlson index and the trans‑nosological comorbidity index determined the cumulative survival of CLL patients; the presence of three or more concurrent diseases and/or Charlson index >3 suggested a poor prognosis for patients with CLL. Conclusion: Diagnosis and treatment of comorbidities in patients with CLL require participation of different medical specialists working in a close contact with oncohematologists.