title: Charlson comorbidity index predicts poor outcome in CML patients treated with tyrosine kinase inhibitor.
abstract: Although the Sokal and Hasford scoring systems are well-known prognostic models specific to chronic myeloid leukemia (CML), whether they can effectively predict outcomes in elderly CML patients with comorbidities has not been fully elucidated. We evaluated the association between comorbidity at diagnosis with treatment outcome and survival in chronic phase CML patients. A questionnaire was administered to patients diagnosed with CML between 2001 and 2012 and treated with tyrosine kinase inhibitors (TKIs). The Charlson comorbidity index (CCI) was used to determine concomitant diseases. In total, 79 patients (33 females; median age, 57 years) were enrolled. CCI scores at diagnosis were between 2 and 11. At the last follow-up, 46 patients showed a major molecular response. Complete cytogenetic response was achieved in 73.4 % of the cases 12 months after TKI administration. We observed only five deaths during the 55.5-month median follow-up period. The risk categories (low/intermediate/high) associated with Sokal and Hasford scores were 33/27/7 and 21/43/3, respectively. The 27 cases with a CCI score >3 had significantly poorer survival after diagnosis (52 cases had a CCI score <2). CCI scores were inversely associated to overall survival. Concomitant comorbidity at diagnosis is associated with poor outcome in CML patients treated with TKIs.
authors: Division of Hematology, Rheumatology and Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine, Kagawa University, Miki-town, Japan.
authors: Makiko
authors: M
authors: Uemura
authors: Division of Hematology, Rheumatology and Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine, Kagawa University, Miki-town, Japan. oima@med.kagawa-u.ac.jp.|Division of Hematology and Stem Cell Transplantation, Department of Internal Medicine, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-town, Kagawa, 761-0793, Japan. oima@med.kagawa-u.ac.jp.
authors: Osamu
authors: O
authors: Imataki
authors: Division of Hematology, Department of Internal Medicine, Kaisei General Hospital, The Taijukai Foundation, Sakaide City, Kagawa, 762-0007, Japan.|Division of Hematology, Department of Internal Medicine, Takamatsu Red Cross Hospital, 4-1-3 Ban-cho, Takamatsu City, Kagawa, 760-0017, Japan.
authors: Yasunori
authors: Y
authors: Kawachi
authors: Division of Hematology, Department of Internal Medicine, Kagawa Prefectural Central Hospital, 5-4-16 Ban-cho, Takamatsu City, Kagawa, 760-8557, Japan.
authors: Kimihiro
authors: K
authors: Kawakami
authors: Department of Internal Medicine, Takamatsu Municipal Hospital, 2-36-1 Miyawaki-cho, Takamatsu City, Kagawa, 760-8538, Japan.
authors: Yasuo
authors: Y
authors: Hoshijima
authors: Department of Internal Medicine, Sakaide City Hospital, 1-6-43 Bunkyo-cho, Sakaide City, Kagawa, 762-0031, Japan.|Division of Hematology, Department of Internal Medicine, Mitoyo General Hospital, 708 Himehama, Toyohama-cho, Kanonji City, Kagawa, 769-1695, Japan.
authors: Akihito
authors: A
authors: Matsuoka
authors: Division of Hematology, Rheumatology and Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine, Kagawa University, Miki-town, Japan.
authors: Norimitsu
authors: N
authors: Kadowaki
mesh_terms: D015897:Comorbidity; D005260:Female; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality; D008297:Male; D008875:Middle Aged; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use*; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D047428:Protein Kinase Inhibitors; D011505:Protein-Tyrosine Kinases
keywords: Charlson comorbidity index; Chronic myeloid leukemia; Hasford score; Sokal score; Tyrosine kinase inhibitor