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The impact of comorbidity on health-related quality of life in elderly patients with chronic myeloid leukemia

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Abstract

The primary objective of this study was to investigate whether the presence of comorbidities was associated with a lower health-related quality of life (HRQOL) in elderly patients with chronic myeloid leukemia (CML). A sample of 174 CML patients aged 60 years or above was analyzed. HRQOL was assessed with the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). A number of pre-selected sociodemographic and disease-related factors were considered as potential confounding factors for the association between comorbidity and HRQOL. Mean age of the 174 patients analyzed was 70 years (range 60–87 years) and 55 % were male. Overall, 111 patients (64 %) reported at least one comorbidity. Analysis stratified by age group category showed a greater proportion of patients with comorbidities in the older sub-group population (≥70 years) compared to younger patients (60 to 69 years). Differences in HRQOL outcomes between patients with no comorbidity at all and those with two or more comorbid conditions were at least twice the magnitude of a clinically meaningful difference in all the physical and mental health scales of the SF-36. In multivariate analysis, after adjusting for key confounding factors, the following scales were significantly lower in those with comorbidity: general health (p < 0.001), bodily pain (p < 0.001), physical functioning (p = 0.002), and vitality (p = 0.002). Assessing comorbidity in elderly patients with CML is important to facilitate identification of those most in need of HRQOL improvements.

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Acknowledgments

We are deeply grateful to all patients who participated in this study. We also thank Alessandro Perreca (from GIMEMA Data Center) for his assistance with data management and administrative support throughout the study period.

Authors’ contributions

FE, MB, MBA, and GR did the conception and design of this study. FC and FE completed the statistical analysis. FE, FC, GR, and MB carried out manuscript writing. All authors did the collection and assembly of data and the final approval of manuscript.

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Authors and Affiliations

  1. Italian Group for Adult Hematologic Diseases (GIMEMA), GIMEMA Data Center and Health Outcomes Research Unit, Via Benevento, 6, 00161, Rome, Italy

    F. Efficace, F. Cottone, J. M. Giesinger & F. Mandelli

  2. Department of Hematology-Oncology, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy

    G. Rosti & M. Baccarani

  3. Department of Biotechnologies and Hematology, University of Rome Sapienza, Rome, Italy

    M. Breccia

  4. Hematology Section, Department of Biomedical Sciences, University of Catania, Catania, Italy

    F. Stagno

  5. Oncohematology of the Elderly Unit, Division of Oncohematology, IRCCS Ca’Granda Maggiore University Hospital, Milan, Italy

    A. Iurlo

  6. Department of Hematology, University of Bari, Bari, Italy

    A. Russo Rossi

  7. Department of Hematology, University of Naples Federico II, Naples, Italy

    L. Luciano

  8. Department of Hematology, Ospedali Riuniti, Reggio Calabria, Italy

    B. Martino

  9. Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy

    S. Galimberti

  10. Department of Hematology, Hospital Cervello, Palermo, Italy

    D. Turri

  11. Clinica Ematologica, IRCCS AOU San Martino-IST Genova, Genova, Italy

    M. Bergamaschi

  12. Division of Hematology and BMT, Azienda Ospedaliero-Universitaria di Udine, Udine, Italy

    M. Tiribelli

  13. Division of Haematology and Internal Medicine, Department of Clinical and Biological Science, University of Turin, Turin, Italy

    C. Fava

  14. UO Ematologia e Centro Trapianti Ospedale Oncologico di Riferimento Regionale “Armando Businco”, Cagliari, Italy

    E. Angelucci

Authors
  1. F. Efficace
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  2. G. Rosti
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  3. M. Breccia
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  4. F. Cottone
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  5. J. M. Giesinger
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  6. F. Stagno
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  7. A. Iurlo
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  8. A. Russo Rossi
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  9. L. Luciano
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  10. B. Martino
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  11. S. Galimberti
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  12. D. Turri
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  13. M. Bergamaschi
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  14. M. Tiribelli
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  15. C. Fava
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  16. E. Angelucci
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  17. F. Mandelli
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  18. M. Baccarani
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Corresponding author

Correspondence to F. Efficace.

Ethics declarations

Ethic committees of participating centers approved the study. All patients provided written informed consent.

Funding

This study was funded by the “Associazione Italiana contro le Leucemie, Linfomi e Mieloma (AIL)”.

The work of Johannes M. Giesinger has been funded by a grant from the Austrian Science Fund (FWF J3353).

Conflict of interest

The authors declare that they have no conflict of interest.

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Efficace, F., Rosti, G., Breccia, M. et al. The impact of comorbidity on health-related quality of life in elderly patients with chronic myeloid leukemia. Ann Hematol 95, 211–219 (2016). https://doi.org/10.1007/s00277-015-2541-6

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  • DOI: https://doi.org/10.1007/s00277-015-2541-6

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