A recent study examined the impact of age on clinical outcomes for patients diagnosed with chronic lymphocytic leukemia (CLL). This study was published in the journal Blood Advances.
All patients in this trial were treated with a drug called ibrutinib.
The researchers uncovered that age does not independently predict outcomes for this patient population.
Age in CLL
CLL is commonly diagnosed in patients between the ages of 65 and 74. In general, we know that comorbidities and age can predict tolerance of treatment.
The cumulative illness rating scale (CIRS) is used to understand which patients might experience adverse events to treatment based on their demographics and other factors.
Although, compared to other treatments, ibrutinib has demonstrated superior outcomes, adverse outcomes are unfortunately not uncommon.
This trial aimed to evaluate which factors may lead to a higher risk of negative outcomes.
This study included 712 CLL patients. The average age of participants was 70.1 years, but ages ranged from 40 to 95. This trial was majority male (67.1%). Further, 84.4% of the patients had an Eastern Cooperative Oncology Group performance status score of either 0 or 1. The average CIRS score for patients was 5 but ranged from 0 to 30.
Researchers studied five different outcomes in this investigation. They sought to understand factors which may lead to event free survival (EFS), progression free survival (PFS), overall survival (OS), permanent dose reduction (PDR), and toxicity related discontinuation (Tox-DTD).
They found that age did not independently predict any of these 5 outcomes.
However, they did find that performance status and CIRS score did predict some of these outcomes.
First, performance status impacted EFS, PFS, OS, as well as Tox-DTD. It did not independently predict PDR. Second, an organ which was severely impaired by CIRS criteria did predict PDR. A 17p deletion as well as a TP53 mutation was predictive of OS, EFS, and PFS but not PDR or Tox-DTD.
The researchers emphasize that this study did have limitations because it was retrospective in nature. Nonetheless, there are some important findings. First, age doesn’t independently matter. Additionally, a CIRS of more than 6 does predict outcomes independently.
Tedeschi A, Frustaci AM, Mauro FR, et al. Do age, fitness, and concomitant medications influence management and outcomes of patients with CLL treated with ibrutinib? Blood Adv. 2021;5(24):5490-500. doi:10.1182/bloodadvances.2021004824
You can read more about this study and its findings here.