Department of Hematology, Rigshospitalet, Copenhagen, Denmark.
Hematology Group, Danish Cancer Society Research Center, Copenhagen, Denmark.
Am J Hematol. 2023 Aug;98(8):1236-1245. doi: 10.1002/ajh.26964. Epub 2023 May 22.
Age-related comorbid conditions are exceedingly common in patients with chronic lymphocytic leukemia (CLL). As the prevalence of type 2 diabetes (T2D) is predicted to double during the next two decades, a better understanding of the interplay between CLL and T2D is of increasing importance. In this study, analyses were performed in parallel in two separate cohorts, based on Danish national registers and the Mayo Clinic CLL Resource. The primary outcomes were overall survival (OS) from time of CLL diagnosis, OS from time of treatment, and time to first treatment (TTFT), studied using Cox proportional hazard regression analysis and Fine-Gray regression analysis. In the Danish CLL cohort, the prevalence of T2D was 11%, in the Mayo CLL cohort, it was 12%. Patients with CLL and T2D had shorter OS both from time of diagnosis and from first-line treatment for were less likely to receive treatment for CLL compared with patients with CLL and without T2D. The increased mortality was largely driven by an increased risk of death due to infections, especially in the Danish cohort. The findings of this study emphasize a substantial subgroup of CLL patients with co-occurring T2D with an inferior prognosis and a possible unmet treatment need requiring additional interventions and further research.
年龄相关的合并症在慢性淋巴细胞白血病（CLL）患者中极为常见。由于 2 型糖尿病（T2D）的患病率预计在未来 20 年内将翻一番，因此更好地了解 CLL 和 T2D 之间的相互作用变得越来越重要。在这项研究中，根据丹麦国家登记处和梅奥诊所 CLL 资源，在两个独立队列中并行进行了分析。主要结局是从 CLL 诊断时的总体生存（OS）、从治疗时的 OS 和首次治疗的时间（TTFT），使用 Cox 比例风险回归分析和 Fine-Gray 回归分析进行研究。在丹麦 CLL 队列中，T2D 的患病率为 11%，在梅奥 CLL 队列中，T2D 的患病率为 12%。患有 CLL 和 T2D 的患者的 OS 均较从诊断时间和一线治疗时间均较短，与患有 CLL 但没有 T2D 的患者相比，他们接受 CLL 治疗的可能性较低。死亡率的增加主要是由于感染导致的死亡风险增加，尤其是在丹麦队列中。这项研究的结果强调了一个存在 T2D 的 CLL 患者亚组，他们的预后较差，可能存在未满足的治疗需求，需要额外的干预措施和进一步的研究。
