Impact of type 2 diabetes on mortality, cause of death, and treatment in chronic lymphocytic leukemia

Emelie Curovic Rotbain*, Cristine Allmer, Klaus Rostgaard, Michael Asger Andersen, Noomi Vainer, Caspar da Cunha-Bang, Sameer A Parikh, Kari G Rabe, Henrik Hjalgrim, Henrik Frederiksen, Susan L Slager, Carsten Utoft Niemann

*Corresponding author for this work

Abstract

Age-related comorbid conditions are exceedingly common in patients with chronic lymphocytic leukemia (CLL). As the prevalence of type 2 diabetes (T2D) is predicted to double during the next two decades, a better understanding of the interplay between CLL and T2D is of increasing importance. In this study, analyses were performed in parallel in two separate cohorts, based on Danish national registers and the Mayo Clinic CLL Resource. The primary outcomes were overall survival (OS) from time of CLL diagnosis, OS from time of treatment, and time to first treatment (TTFT), studied using Cox proportional hazard regression analysis and Fine-Gray regression analysis. In the Danish CLL cohort, the prevalence of T2D was 11%, in the Mayo CLL cohort, it was 12%. Patients with CLL and T2D had shorter OS both from time of diagnosis and from first-line treatment for were less likely to receive treatment for CLL compared with patients with CLL and without T2D. The increased mortality was largely driven by an increased risk of death due to infections, especially in the Danish cohort. The findings of this study emphasize a substantial subgroup of CLL patients with co-occurring T2D with an inferior prognosis and a possible unmet treatment need requiring additional interventions and further research.

Original languageEnglish
JournalAmerican Journal of Hematology
Volume98
Issue number8
Pages (from-to)1236-1245
Number of pages10
ISSN0361-8609
DOIs
Publication statusPublished - Aug 2023

Keywords

  • Cause of Death
  • Diabetes Mellitus, Type 2/complications
  • Humans
  • Leukemia, Lymphocytic, Chronic, B-Cell/complications
  • Prognosis

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