title: The impact of comorbidity on health-related quality of life in elderly patients with chronic myeloid leukemia.
abstract: The primary objective of this study was to investigate whether the presence of comorbidities was associated with a lower health-related quality of life (HRQOL) in elderly patients with chronic myeloid leukemia (CML). A sample of 174 CML patients aged 60 years or above was analyzed. HRQOL was assessed with the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). A number of pre-selected sociodemographic and disease-related factors were considered as potential confounding factors for the association between comorbidity and HRQOL. Mean age of the 174 patients analyzed was 70 years (range 60-87 years) and 55 % were male. Overall, 111 patients (64 %) reported at least one comorbidity. Analysis stratified by age group category showed a greater proportion of patients with comorbidities in the older sub-group population (≥70 years) compared to younger patients (60 to 69 years). Differences in HRQOL outcomes between patients with no comorbidity at all and those with two or more comorbid conditions were at least twice the magnitude of a clinically meaningful difference in all the physical and mental health scales of the SF-36. In multivariate analysis, after adjusting for key confounding factors, the following scales were significantly lower in those with comorbidity: general health (p < 0.001), bodily pain (p < 0.001), physical functioning (p = 0.002), and vitality (p = 0.002). Assessing comorbidity in elderly patients with CML is important to facilitate identification of those most in need of HRQOL improvements.
authors.affiliation: Italian Group for Adult Hematologic Diseases (GIMEMA), GIMEMA Data Center and Health Outcomes Research Unit, Via Benevento, 6, 00161, Rome, Italy. f.efficace@gimema.it.
authors.forename: F
authors.initials: F
authors.lastname: Efficace
authors.affiliation: Department of Hematology-Oncology, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Rosti
authors.affiliation: Department of Biotechnologies and Hematology, University of Rome Sapienza, Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Breccia
authors.affiliation: Italian Group for Adult Hematologic Diseases (GIMEMA), GIMEMA Data Center and Health Outcomes Research Unit, Via Benevento, 6, 00161, Rome, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Cottone
authors.affiliation: Italian Group for Adult Hematologic Diseases (GIMEMA), GIMEMA Data Center and Health Outcomes Research Unit, Via Benevento, 6, 00161, Rome, Italy.
authors.forename: J M
authors.initials: JM
authors.lastname: Giesinger
authors.affiliation: Hematology Section, Department of Biomedical Sciences, University of Catania, Catania, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Stagno
authors.affiliation: Oncohematology of the Elderly Unit, Division of Oncohematology, IRCCS Ca'Granda Maggiore University Hospital, Milan, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Iurlo
authors.affiliation: Department of Hematology, University of Bari, Bari, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Russo Rossi
authors.affiliation: Department of Hematology, University of Naples Federico II, Naples, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Luciano
authors.affiliation: Department of Hematology, Ospedali Riuniti, Reggio Calabria, Italy.
authors.forename: B
authors.initials: B
authors.lastname: Martino
authors.affiliation: Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Galimberti
authors.affiliation: Department of Hematology, Hospital Cervello, Palermo, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Turri
authors.affiliation: Clinica Ematologica, IRCCS AOU San Martino-IST Genova, Genova, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Bergamaschi
authors.affiliation: Division of Hematology and BMT, Azienda Ospedaliero-Universitaria di Udine, Udine, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Tiribelli
authors.affiliation: Division of Haematology and Internal Medicine, Department of Clinical and Biological Science, University of Turin, Turin, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Fava
authors.affiliation: UO Ematologia e Centro Trapianti Ospedale Oncologico di Riferimento Regionale "Armando Businco", Cagliari, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Angelucci
authors.affiliation: Italian Group for Adult Hematologic Diseases (GIMEMA), GIMEMA Data Center and Health Outcomes Research Unit, Via Benevento, 6, 00161, Rome, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Mandelli
authors.affiliation: Department of Hematology-Oncology, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Baccarani
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006306:Health Surveys / Q000379:methods; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000453:epidemiology* / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000453:epidemiology / Q000523:psychology; D010146:Pain / Q000453:epidemiology / Q000523:psychology; D011788:Quality of Life / Q000523:psychology*
keywords: Chronic myeloid leukemia; Comorbidity; Quality of life