Younger Patients with CLL/SLL Are Less Frequent and Have Favorable Survival in a Canadian Population Based Study: The Manitoba Cohort.
Notice bibliographique
Résumé
Abstract Background: Detailed population-based clinical characteristics and outcomes of chronic lymphocytic leukemia (CLL) and small lymphocytic leukemia (SLL) are scarce. We have previously demonstrated in the province of Manitoba that by combining population-based sources of a cancer registry and a centralized flow cytometry database, the incidence of CLL/SLL is much higher than previously reported. We have now examined the clinical characteristics of this large and well defined patient group. We hypothesized that the clinical features of these patients (pts) may differ from previous studies where data was obtained from referral centers. Methods: All pts from the Manitoba Cancer Registry with ICD codes 9 & 10 for CLL or SLL from 01/01/1998 to 12/31/2003 were identified. Pts from the flow cytometry database during this time period with a diagnosis of CLL/SLL were also identified. A retrospective electronic chart review was conducted. The two databases were compared and analyzed. Results: 715 pts with CLL were identified. 358 pts were identified from the cancer registry alone, 136 pts by the flow cytometry database, and 221 pts in both datasets. Overall, the age-adjusted annual incidence rate of CLL/SLL in Manitoba was 10.5/105 (95% C.I. 9.4–12.7/105). Median age of all pts was 72yrs (19–101). Only 71 pts (9.9%) were aged <55 and 212 pts (29.6) were <65. The Male: Female ratio was identical in the age<55 and >55 categories (1.33). Median follow-up of living pts is 6.6 years (range 2.0–8.0). The Cox regression model was used to evaluate the significance of prognostic factors including age at diagnosis and gender. Older cases (>55 years) had significantly higher risk of dying (HR: 4.0, 95%CI: 1.23–13.1) than younger pts. Women had a slightly lower risk of dying (HR: 0.78, 95%CI: 0.40–1.50) than men. For the 136 pts for whom accurate Rai staging was available, estimated median survival has not been reached in stage 0 patients, while it was 7.2 years in stage I–II cases and 4.5 years in stage III–IV patients. Cause specific mortality and complete survival according to Rai stage for all pts will be presented at the meeting. Conclusions: In this population-based CLL/SLL cohort, clinical presentation and outcomes appear to differ from previously reported studies. Specifically, (1) there are fewer younger pts, (2) the male: female ratio is similar amongst all ages, (3) older pts have a significantly poorer survival, (4) pts with advanced Rai stages appear to live longer than previously reported. This has important implications for treatment and counseling of pts, as well as for resource allocation for this common hematological malignancy.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,003 |
| Études des sciences et des technologies | 0,002 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».