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treatment-free interval length high-grade b-cell lymphoma chronic lymphocytic leukaemia stefanie hieke-schulz full size image chronic lymphocytic leukemia cox proportional-hazards model risk profiles article download pdf view original author cll-ipi scoring system cll international prognostic index high-risk disease features fixed-duration ibrutinib-venetoclax hospital-based cancer registry ighv mutation status real-world relapsed/refractory rainer claus post 2014 introduction molecular markers cs-based prognostic information mutation status play high-risk cll-ipi ighv-mutated patients reflect cll-ipi risk groups composite prognostic scores privacy choices/manage cookies article schlosser ighv gene locus full access international prognostic index author correspondence german cancer aid comprehensive cancer center local ethics committee conditional survival estimates including baseline characteristics conditional relative survival conditional survival approach perfectly parallel curves small lymphocytic lymphoma community-based cohorts high-risk patients defined risk parameters including updating survival estimates long-term prognostic kaplan–meier method [18] kaplan–meier curves conditional survival cs

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         headline:Conditional survival to assess prognosis in patients with chronic lymphocytic leukemia
         description:Biomarkers in chronic lymphocytic leukemia (CLL) allow assessment of prognosis. However, the validity of current prognostic biomarkers based on a single assessment point remains unclear for patients who have survived one or more years. Conditional survival (CS) studies that address how prognosis may change over time, especially in prognostic subgroups, are still rare. We performed CS analyses to estimate 5-year survival in 1-year increments, stratified by baseline disease characteristics and known risk factors in two community-based cohorts of CLL patients (Freiburg University Hospital (n = 316) and Augsburg University Hospital (n = 564)) diagnosed between 1984 and 2021. We demonstrate that 5-year CS probability is stable (app. 75%) for the entire CLL patient cohort over 10 years. While age, sex, and stage have no significant impact on CS, patients with high-risk disease features such as non-mutated IGHV, deletion 17p, and high-risk CLL-IPI have a significantly worse prognosis at diagnosis, and 5-year CS steadily decreases with each additional year survived. Our results confirm that CLL patients have a stable survival probability with excess mortality and that the prognosis of high-risk CLL patients declines over time. We infer that CS-based prognostic information is relevant for disease management and counseling of CLL patients.
         datePublished:2024-02-03T00:00:00Z
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      headline:Conditional survival to assess prognosis in patients with chronic lymphocytic leukemia
      description:Biomarkers in chronic lymphocytic leukemia (CLL) allow assessment of prognosis. However, the validity of current prognostic biomarkers based on a single assessment point remains unclear for patients who have survived one or more years. Conditional survival (CS) studies that address how prognosis may change over time, especially in prognostic subgroups, are still rare. We performed CS analyses to estimate 5-year survival in 1-year increments, stratified by baseline disease characteristics and known risk factors in two community-based cohorts of CLL patients (Freiburg University Hospital (n = 316) and Augsburg University Hospital (n = 564)) diagnosed between 1984 and 2021. We demonstrate that 5-year CS probability is stable (app. 75%) for the entire CLL patient cohort over 10 years. While age, sex, and stage have no significant impact on CS, patients with high-risk disease features such as non-mutated IGHV, deletion 17p, and high-risk CLL-IPI have a significantly worse prognosis at diagnosis, and 5-year CS steadily decreases with each additional year survived. Our results confirm that CLL patients have a stable survival probability with excess mortality and that the prognosis of high-risk CLL patients declines over time. We infer that CS-based prognostic information is relevant for disease management and counseling of CLL patients.
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      dateModified:2024-02-03T00:00:00Z
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               type:PostalAddress
            type:Organization
            name:University Medical Center Freiburg
            address:
               name:Department of Hematology, Oncology and Stem Cell Transplantation, University Medical Center Freiburg, Freiburg, Germany
               type:PostalAddress
            type:Organization
            name:University of Augsburg
            address:
               name:Pathology, Faculty of Medicine, University of Augsburg, Augsburg, Germany
               type:PostalAddress
            type:Organization
            name:University of Augsburg
            address:
               name:Faculty of Medicine, Comprehensive Cancer Center, University of Augsburg, Augsburg, Germany
               type:PostalAddress
            type:Organization
      email:[email protected]
PostalAddress:
      name:Institute of Genetic Epidemiology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
      name:Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
      name: Centre for Integrative Biological Signalling Studies (CIBSS), University of Freiburg, Freiburg, Germany
      name:Hematology/Oncology, Faculty of Medicine, University of Augsburg, Augsburg, Germany
      name:Department of Hematology, Oncology and Stem Cell Transplantation, University Medical Center Freiburg, Freiburg, Germany
      name:Institute of Medical Biometry and Medical Informatics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
      name:Roche Pharma AG, Grenzach-Wyhlen, Germany
      name:Department of Hematology, Oncology and Stem Cell Transplantation, University Medical Center Freiburg, Freiburg, Germany
      name:Department of Hematology, Oncology and Stem Cell Transplantation, University Medical Center Freiburg, Freiburg, Germany
      name:Hematology/Oncology, Faculty of Medicine, University of Augsburg, Augsburg, Germany
      name:Department of Hematology, Oncology and Stem Cell Transplantation, University Medical Center Freiburg, Freiburg, Germany
      name:Tumor- Und BrustZentrum Ostschweiz, Chur, Switzerland
      name:Institute of Medical Biometry and Medical Informatics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
      name:Hematology/Oncology, Faculty of Medicine, University of Augsburg, Augsburg, Germany
      name:Department of Hematology, Oncology and Stem Cell Transplantation, University Medical Center Freiburg, Freiburg, Germany
      name:Pathology, Faculty of Medicine, University of Augsburg, Augsburg, Germany
      name:Faculty of Medicine, Comprehensive Cancer Center, University of Augsburg, Augsburg, Germany

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