Improving survival in patients with chronic lymphocytic leukemia (1980-2008):
the Hospital Clinic of Barcelona experience.
Pau Abrisqueta, Arturo Pereira, Ciril Rozman, Marta Aymerich, Eva Gine, Carol
Moreno, Ana Muntanola, Maria Rozman, Neus Villamor, Kate Hodgson, Elias Campo,
Francesc Bosch, and Emili Montserrat
Blood, June 24, 2009;

Institute of Hematology and Oncology, Department of Hematology, Hospital Clinic
IDIBAPS, University of Barcelona, Barcelona, Spain.

Whether advances in treatment are prolonging survival of patients with CLL
is unclear. We analyzed presentation patterns and survival over the time in 929
patients followed from 1980 to 2008 at the Hospital Clinic of Barcelona. The 5-
and 10-year relative survival (adjusted for the expected survival in the general
population) was estimated in patients seen in two periods of time: 1980-1994
(n=451) and 1995-2004 (n=365). We found that CLL shortens life expectancy in all
age groups independently of clinical features at diagnosis. Nevertheless,
survival is improving, particularly in some groups of patients. Thus, relative
survival was significantly higher in the 1995-2004 cohort than in the 1980-1994
group both at 5 years [Incidence rate ratio (IRR): 0.46, p=0.004] and 10 years
(IRR: 0.65, p=0.007) from diagnosis. The improved survival was largely due to a
decrease in CLL-attributable mortality in patients less than 70 years-old in
Binet stage B or C at diagnosis (IRR: 0.40, p=0.001, and IRR=0.33, p<0.001, at 5
and 10 years, respectively). These results suggest that newer treatments are
changing the prognosis of CLL, particularly in younger patients with advanced
disease, while no improvement is yet observed in older subjects or those with
lower-risk disease.
PMID: 19553638




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