CM-03. Kidney function and survival of patients with chronic lymphocytic leukemia
Maria V. Markovtseva1, Ekaterina N. Zguralskaya2
1 Ulyanovsk State University, Ulyanovsk, Russia
2 Ulyanovsk State Technical University, Ulyanovsk, Russia
Contact: Dr. Maria V. Markovtseva, phone: +7 (902) 356-54-72, e-mail: email@example.com
Chronic lymphocytic leukemia (CLL), as well as chronic kidney disease (CKD), mainly occur in the elderly (60-75 years) and senile (over 75 years) age. It is also known that a decrease in glomerular filtration rate (GFR) and the CKD presence have drastic influence on long-term prognosis. The aim of the study was analyzing the CKD occurrence in CLL patients and assessment of their impact on survival.
Materials and methods
A total of 132 CLL patients (60 men and 72 women) with known overall survival observed in GUZ UOKB hematology department from 01.2010 to 02.2020 were included in this retrospective cohort. Patients with HIV infection, tuberculosis and other paraneoplastic processes were excluded from the study. At the time of CLL diagnosis the GFR was calculated by CKD-EPI formula and CKD presence was assessed in accordance with CKD stage classification and stratification in accordance with GFR value. An end-to-end linear correlation analysis of the obtained Pearson indicators was carried out.
The average patients’ age was 66.0±10.3 years. Among the studied cohort 64 (48.5%) patients had CKD with stage C2 found in 23 (17.4%), and stage C3a in 41 (31.1%) patients. This CKD rate in studied cohort significantly exceeds the one described by national epidemiological studies, which have detected CKD in 36% of studied patients older than 60 (Bikbov B.T. et al., 2009). The CKD structure depending on the CLL stage (Binet classification) was as follows: The CKD C2 stage was registered in 8.3%, 7.6%, and 1.5% of cases of CLL A, B, C, respectively. CKD C3a stage was diagnosed, respectively, in 9.8%, 18.9%, and 2.3% of CLL A, B, and C, respectively. It should be noted that there is no connection between CLL stage and CKD severity. However, this confirms the earlier published data stating no such relationship [Erten N. et al., 2005]. The studied cohort analysis showed only 43 (32.5%) patients to overcome estimated median survival rate in accordance with Binet classification. Of particular interest is the fact that a strong inverse correlation was found between C3a CKD and survival (p<0.05). We have previously found that initial GFR of more than 76.5 ml/min/1.73 m2 in newly diagnosed CLL patient may predict the survival exceeding one calculated by median survival according to Binet classification (Patent RU No. 2725877 C1; 2020). Patients with CKD C3a do not belong to this category. In study conducted there were no patients with CKD C3a at the CLL diagnosis who did not exceed estimated median survival according to Binet classification.
In the cohort studied, the CKD C3a stage had a significant impact on CLL patients’ survival. Careful GFR monitoring starting at diagnosis will optimize the prognosis in this category of patients.
Chronic lymphocytic leukemia, chronic kidney disease, overall survival.