Detailing the Clinical Characteristics of CLL in Adolescents, Young Adults

Researchers sought to describe clinical and sociodemographic characteristics, prognostic factors, and survival in adolescents and young adults (AYAs) diagnosed with chronic lymphocytic leukemia (CLL). Their findings were presented at the 65th ASH Annual Meeting & Exposition, which is taking place December 9-12 in San Diego, California.

Henry Becerra, MD, and colleagues analyzed 51,992 cases of CLL from the Surveillance, Epidemiology, and End Results Program database from 2000 to 2020. They used the Kaplan-Meier method to estimate median overall survival (OS) and Cox regression analysis to identify independent prognostic factors of survival.

The analysis showed that AYA patients made up 1% of the study population. The AYA patients were 66.1% male and 70.3% non-Hispanic White. A total of 90.2% of AYA patients lived in metropolitan areas, and the average income was $75,000 or higher for 45.6%. Chemotherapy was received by 32.7% of patients and radiation therapy was given to 1.6%, the researchers noted. Median OS was not reached in the AYA population, with a 5-year and 10-year OS of 91% and 84%, respectively. Moreover, OS was found to be different between AYA patients and the older population, and age was an independent prognostic factor for survival in the entire population of patients with CLL (P<.001).

A multivariate analysis specific to the AYA population showed American Indian/Alaska Native non-Hispanic patients had poor prognosis compared with other races (hazard ratio [HR], 19.1; 95% CI, 2.2-166.5; P=.008). Furthermore, receiving radiotherapy was correlated with poor prognosis in AYA patients (HR, 5.5; 95% CI, 1.6-19.6; P=.008). Compared with lower-income (<$35,000) patients, all patients with a higher income had better prognosis (for patients with ≥$75,000 median income: HR, 0.01; 95% CI, 0.001-0.11; P<.001).

“To the best of our knowledge, this is the largest epidemiological study available for CLL in AYA to this date. Sociodemographic differences and epidemiologic prognostic factors described in this research contribute to understanding this disease,” the investigators concluded.

Reference

Becerra H, Illerhunmwuwa N, Wasifuddin M, Uche I, Wang J-C. Chronic lymphocytic leukemia (CLL) in adolescents and young adults (AYA): clinical characteristics, prognostic factors and survival for 498 patients. Abstract #1918. Presented at the 65th ASH Annual Meeting & Exposition; December 9-12, 2023; San Diego, California.