title: Improving survival in patients with chronic lymphocytic leukemia (1980-2008): the Hospital Clinic of Barcelona experience.
abstract: Whether advances in treatment are prolonging survival of patients with chronic lymphocytic leukemia (CLL) is unclear. We analyzed presentation patterns and survival over 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 2 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 = .004) and 10 years (IRR = 0.65; P = .007) from diagnosis. The improved survival was largely due to a decrease in CLL-attributable mortality in patients younger than 70 years in Binet stage B or C at diagnosis (IRR = 0.40; P = .001 at 5 years; IRR = 0.33; P < .001 at 10 years). These results suggest that newer treatments are changing the prognosis of CLL, particularly in younger patients with advanced disease, whereas no improvement is yet observed in older subjects or those with lower-risk disease.
authors: Department of Hematology, Institute of Hematology and Oncology, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain.
authors: Pau
authors: P
authors: Abrisqueta
authors: Arturo
authors: A
authors: Pereira
authors: Ciril
authors: C
authors: Rozman
authors: Marta
authors: M
authors: Aymerich
authors: Eva
authors: E
authors: Giné
authors: Carol
authors: C
authors: Moreno
authors: Ana
authors: A
authors: Muntañola
authors: María
authors: M
authors: Rozman
authors: Neus
authors: N
authors: Villamor
authors: Kate
authors: K
authors: Hodgson
authors: Elías
authors: E
authors: Campo
authors: Francesc
authors: F
authors: Bosch
authors: Emili
authors: E
authors: Montserrat
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D006779:Hospitals, Public; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000401:mortality* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013030:Spain; D015996:Survival Rate