Demographics and survival in B-Cell prolymphocytic leukemia: An analysis of SEER data.
Journal of Hematology
Purpose of the Study: B-cell prolymphocytic leukemia (B-PLL) is a very infrequent B cell neoplasm. Because of its rarity, the demo- graphics and prognosis of B-PLL patients are poorly characterized. The purpose of this analysis was to explore the impact of patient fac- tors on prognosis and that of chemotherapy on survival in B-PLL. Summarized Description of the Project: Using ICD-O-3 histology code 9833/3 in the Surveillance Epidemiology and End Results data- base (SEER), we retrospectively collected demographic and survival data on metastatic B-PLL diagnosed between 2000 and 2016. Kaplan- Meier curves and Cox proportional hazards were used to perform timed analysis in JMP 14 statistical software. Results: Over 17 years, 289 patients were diagnosed with B-PLL. The median age at diagnosis was 74 years; 182 (63%) were men and 254 (88%) were Caucasian. During the observation period, 205 (71%) patients died and death was attributable to B-PLL in 99 (48%). Median overall survival (OS) was 25 months (Figure - left panel); survival was better for patients who did not receive chemotherapy in the unadjusted analysis (median OS 30 months vs 22 months, Figure - right panel), but this difference was not statistically significant (log-rank p=0.97). A proportional hazards model including age, sex, ethnicity, and treatment identified Caucasian race (HR 1.82 [95% CI 1.11-3.24], p=0.01) and advanced age at diagnosis (HR 1.05 per unit increase [95% CI 1.04-1.07], p < 0.0001) as predictors of decreased survival. In the adjusted analysis, the use of chemotherapy was similarly associated with worse survival (HR 1.26 [95% CI 0.95-1.67]), but the difference did not reach significance (p=0.1). Conclusion: B-PLL is rare, with under 300 cases identified over 17 years. It affects primarily men in their eighth decade of life and has a poor prognosis. Caucasian race may be an important predictor of poor outcome, alon g with advanced age at diagnosis. The use of che mo- therapy appears to have little impact on survival and tended towards an association w ith harm. The SEER database does not provide infor- mation about the type of therapy used or th e clinical behavior of B- PLL, which is recognized as variable. As such, the relative lower sur- vival wit h chemotherapy may reveal the use of therapy for more aggressive disease, rather than increased treatment toxicity.
Ionescu, Filip; Anusim, Nwabundo; Khoury, John; Gaikazian, Susanna; Stender, Michael; and Jaiyesimi, Ishmael, "Demographics and survival in B-Cell prolymphocytic leukemia: An analysis of SEER data." (2019). Conference Presentation Abstracts. 23.