Efficace F, Rosti G, Breccia M, Cottone F, Giesinger J M, Stagno F, Iurlo A, Russo Rossi A, Luciano L, Martino B, Galimberti S, Turri D, Bergamaschi M, Tiribelli M, Fava C, Angelucci E, Mandelli F, Baccarani M
Italian Group for Adult Hematologic Diseases (GIMEMA), GIMEMA Data Center and Health Outcomes Research Unit, Via Benevento, 6, 00161, Rome, Italy.
Department of Hematology-Oncology, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
Ann Hematol. 2016 Jan;95(2):211-9. doi: 10.1007/s00277-015-2541-6. Epub 2015 Nov 7.
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.
本研究的主要目的是调查合并症的存在是否与老年慢性髓性白血病（CML）患者较低的健康相关生活质量（HRQOL）相关。对174例年龄在60岁及以上的CML患者样本进行了分析。使用医学结局研究36项简短健康调查（SF-36）评估HRQOL。一些预先选定的社会人口统计学和疾病相关因素被视为合并症与HRQOL之间关联的潜在混杂因素。所分析的174例患者的平均年龄为70岁（范围60 - 87岁），55%为男性。总体而言，111例患者（64%）报告至少有一种合并症。按年龄组分类进行的分层分析显示，与年轻患者（60至69岁）相比，老年亚组人群（≥70岁）中合并症患者的比例更高。在SF-36所有生理和心理健康量表中，无合并症患者与有两种或更多合并症患者之间的HRQOL结果差异至少是临床有意义差异的两倍。在多变量分析中，在调整关键混杂因素后，合并症患者在以下量表上得分显著更低：总体健康（p < 0.001）、身体疼痛（p < 0.001）、生理功能（p = 0.002）和活力（p = 0.002）。评估老年CML患者的合并症对于确定那些最需要改善HRQOL的患者很重要。
