Vaccine and Drug Evaluation Centre, Department of Community Health Sciences, University of Manitoba, 337-750 McDermot Avenue, Winnipeg, MB, Canada R3E 0T5.
Research Institute of Oncology and Hematology, CancerCare Manitoba, Winnipeg, Manitoba, Canada; Department of Hematology and Oncology, CancerCare Manitoba, Winnipeg, Manitoba, Canada.
Cancer Epidemiol. 2022 Dec;81:102279. doi: 10.1016/j.canep.2022.102279. Epub 2022 Oct 21.
Better CLL patient survival has been reported for specialized CLL clinics/hematologists (compared to other CLL patients). It is possible that improved survival is driven by a better prognosis of referred patients.
We used logistic regression to calculate the odds ratios (ORs) and 95 % confidence intervals 95 %CIs) of the association between patient characteristics and CLL referral of all persons diagnosed in 2005-2016 with a pathologically-confirmed CLL or SLL.
Two-thirds of 1293 patients were referred to the CLL clinic. Referred patients were younger (16 % vs 44 % were 80 +) and in better health (47 % vs 56 % with a chronic diseases) than non-referred patients. Referral increased over time: in 2005-2010, about 60 % of patients were referred; in 2011-2016, this increased to 76 %. Gender did not affect referral (the OR for females is 1.0, 95 %CI 0.8-1.2), but age played a major role; CLL patients diagnosed at age 80 + were less likely to be referred than patients diagnosed < 60, 0.2 (0.1-0.3).
Because referral to Manitoba's specialized CLL clinic is associated with age and the patient's overall health before referral, one should be careful in interpreting differences in outcomes between CLL patients based on referral status alone.
与其他 CLL 患者相比，专门的 CLL 诊所/血液科医生报告称 CLL 患者的生存情况更好。可能是由于转诊患者的预后更好，因此生存率得到了提高。
我们使用逻辑回归计算了 2005 年至 2016 年间所有经病理证实为 CLL 或 SLL 的患者的特征与 CLL 转诊之间的关联的优势比（OR）和 95%置信区间（95%CI）。
1293 名患者中有三分之二被转诊至 CLL 诊所。与未转诊患者相比，转诊患者年龄更小（16%比 44%为 80+），健康状况更好（47%比 56%患有慢性疾病）。转诊的比例随着时间的推移而增加：在 2005 年至 2010 年期间，约有 60%的患者被转诊；在 2011 年至 2016 年期间，这一比例增加到 76%。性别不影响转诊（女性的 OR 为 1.0，95%CI 0.8-1.2），但年龄起主要作用；与<60 岁的患者相比，80+岁诊断为 CLL 的患者不太可能被转诊，0.2（0.1-0.3）。
由于向曼尼托巴省专门的 CLL 诊所转诊与年龄和转诊前患者的整体健康状况相关，因此在仅根据转诊状态解释 CLL 患者的预后差异时应谨慎。
