Tadmor Tamar, Melamed Guy, Alapi Hilel, Gazit Sivan, Patalon Tal, Rokach Lior
Hematology Unit, Bnai Zion Medical Center, and the Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel.
Kahn Sagol Maccabi Research and Innovation Center, Maccabi Healthcare Services, Tel-Aviv, Israel.
Acta Haematol. 2024 Sep 30:1-7. doi: 10.1159/000541453.
Proton pump inhibitors (PPIs) are one of the most widely used drugs worldwide [Gut Liver. 2017;11(1):27-37]. The use of PPI has become a common practice and is overprescribed for all patients with cancer including patients with hematological malignancies. In the current study, we aimed to explore retrospectively the effect of PPI, on time to first treatment (TTFT) in a large cohort of patients with chronic lymphocytic leukemia (CLL) who were under watch-and-wait approach.
The cohort is based on anonymized data obtained from electronic medical records of Maccabi Healthcare Services (MHS) members, who is the second-largest healthcare organization in Israel, with 2.5 million insured patients, and received a diagnosis of CLL during this period.
Our cohort included 3,474 patients with CLL who are treatment-naïve, and the median follow-up was 1,745 days (602-3,700). A total of 1,061 patients (30.5%) received a PPI agent, for a minimum of 3 months during the watch-and-wait period. The intake of PPI was found to be associated with a shorter TTFT: among PPI users, the 10-year treatment-free ratio is 79.2%, while among non-PPI users it is 90.6%.
Routine use of PPI in CLL patients may negatively impact their clinical course. Biology of this primary observation requires further investigation.
质子泵抑制剂（PPIs）是全球使用最广泛的药物之一[《胃肠病与肝脏病学》。2017年；11(1):27 - 37]。PPI的使用已成为一种常见做法，并且在包括血液系统恶性肿瘤患者在内的所有癌症患者中都存在过度处方的情况。在本研究中，我们旨在回顾性探讨PPI对一大群采用观察等待方法的慢性淋巴细胞白血病（CLL）患者首次治疗时间（TTFT）的影响。
该队列基于从Maccabi医疗服务公司（MHS）成员的电子病历中获取的匿名数据，MHS是以色列第二大医疗保健组织，有250万参保患者，在此期间被诊断为CLL。
我们的队列包括3474例未接受过治疗的CLL患者，中位随访时间为1745天（602 - 3700天）。共有1061例患者（30.5%）在观察等待期间至少3个月使用了PPI药物。发现使用PPI与较短的TTFT相关：在PPI使用者中，10年无治疗率为79.2%，而在非PPI使用者中为90.6%。
在CLL患者中常规使用PPI可能对其临床病程产生负面影响。这一初步观察结果的生物学机制需要进一步研究。
