Онкогематология (Jan 2015)
Chronic lymphoproliferative diseases: survival in cohort study of 310 patients (single-center study results and literature data)
Abstract
Introduction. Chronic lymphoproliferative disease (CLPD) are common hematologic malignancies, accompanied by highly variable clinical course, different prognosis and understudied survival as one of the main criteria for long-term treatment efficacy, especially outside of clinical trials.Materials and methods. Patients with CLPD (n = 310) treated in hematology center of Burdenko Main Military Clinical Hospital from June 2003 to September 2014 are included in the study. The diagnosis of specific nosology verified in accordance with national and international recommendations. Analysis of study outcomes was based on overall survival (OS) using the Kaplan–Meier method.Results and discussion. Most patients (mainly with non-Hodgkin»s lymphoma (NHL) – 75 %, or multiple myeloma (MM) – 80.6 %) had advanced disease (III–IV), and 20.3 % admitted to the hospital in poor general condition (ECOG somatic status – 3–4). A significant proportion of patients (38.3 %) with NHL and Hodgkin lymphoma (HL) had a large tumor masses. Median of OS in patients with CLPD was 81.1 months. 5-year survival of total patients from time of diagnosis was 62 %, 10-year survival rate – 37 %. Patients with MM have shortest median of OS – 39 months, while patients with chronic lymphocytic leukemia (CLL) have the longest – 117.8 months. Median OS for NHL patients was 68.1 months, for HL patients – 99.3 months. When comparing survival for two time intervals (2003–2009 and 2009–2014), a tendency to increasethe survival rate for certain groups of patients with CLPD was revealed, that could be due to target therapy and new therapeutic approaches.Conclusion. New drug efficacy for certain diseases has led to renewed interest in the results of CLPD therapy. In our study, most CLPD patients have long-term OS, but the subsequent therapy lines influence on OS requires further study. These results will contribute to new developments in the organization and planning of therapy, changes in therapeutic practice and individualization of treatment.
