Winship Cancer Institute-Hematology and Medical Oncology, Emory University-School of Medicine, Atlanta, GA 30322, USA.
Clin Lymphoma Myeloma Leuk. 2011 Dec;11(6):498-506. doi: 10.1016/j.clml.2011.07.002. Epub 2011 Sep 1.
Chronic lymphocytic leukemia (CLL) is the most common form of adult leukemia in the United States, and prolymphocytic leukemia (PLL) is a related, rare chronic lymphoproliferative disorder.
Using the United States Surveillance, Epidemiology and End Results (SEER) data from 13 registries, we examined differences in incidence and survival for CLL, small lymphocytic lymphoma (SLL) and PLL by race. International Classification of Diseases for Oncology 3(rd) edition histology codes 9670, 9823, and 9632-34 were used to identify cases.
From 1992 to 2007, 30,622 cases of CLL/SLL and 268 cases of PLL were recorded. Males had higher incidence than females (male-to-female incidence rate ratio CLL/SLL 1.89, 95% confidence interval (CI) 1.85-1.94 and PLL 2.47, 95%CI 1.90-3.20). Black patients were diagnosed at younger age compared to white patients (mean age at diagnosis for white versus black patients for CLL/SLL, 70 versus 67 years, P < .001; for PLL, 71 versus 61 years, P < .001). Greater proportion of black patients with SLL presented with B symptoms, extranodal primary site, and advanced disease compared to white patients (P = .003, P = .012, and P = .009 respectively). White patients with CLL/SLL had better survival rates than black patients (5-year relative survival rate 77.1% versus 63.9%, P < .01). In univariate Cox regression models, black race, male gender, age at diagnosis > 65 years, advanced stage, and B-symptoms were predictors of worse survival (P < .01) among CLL/SLL patients.
Black patients with CLL/SLL and PLL present at younger age and black patients with CLL/SLL have worse survival than white patients. Epidemiological studies examining the biological variants of these diseases in concert with race are needed to elucidate the etiology of these disparities.
慢性淋巴细胞白血病（CLL）是美国最常见的成人白血病形式，而成淋巴细胞白血病（PLL）是一种相关的罕见慢性淋巴细胞增生性疾病。
使用来自 13 个登记处的美国监测、流行病学和最终结果（SEER）数据，我们按种族检查了 CLL、小淋巴细胞淋巴瘤（SLL）和 PLL 的发病率和生存率差异。国际肿瘤学疾病分类第 3 版组织学代码 9670、9823 和 9632-34 用于识别病例。
1992 年至 2007 年，记录了 30622 例 CLL/SLL 和 268 例 PLL。男性的发病率高于女性（CLL/SLL 的男性与女性发病率比为 1.89，95%置信区间[CI]为 1.85-1.94，PLL 为 2.47，95%CI 为 1.90-3.20）。与白人患者相比，黑人患者的诊断年龄更小（白人患者与黑人患者的 CLL/SLL 诊断年龄，分别为 70 岁和 67 岁，P<.001；PLL 为 71 岁和 61 岁，P<.001）。与白人患者相比，更多的黑人 SLL 患者表现出 B 症状、结外原发部位和晚期疾病（P=0.003、P=0.012 和 P=0.009）。与白人患者相比，CLL/SLL 的白人患者具有更好的生存率（5 年相对生存率为 77.1%对 63.9%，P<.01）。在单变量 Cox 回归模型中，黑人种族、男性、年龄>65 岁、晚期和 B 症状是 CLL/SLL 患者生存状况较差的预测因素（P<.01）。
患有 CLL/SLL 和 PLL 的黑人患者发病年龄较小，而患有 CLL/SLL 的黑人患者的生存率低于白人患者。需要进行流行病学研究，以检查这些疾病的生物学变异与种族之间的关系，以阐明这些差异的病因。
