ISSN 1866-8836
Клеточная терапия и трансплантация

CM-02. Charlson comorbidity index and survival rate in patients with chronic lymphocytic leukemia

Maria V. Markovtseva

Ulyanovsk State University, Ulyanovsk, Russia

Contact: Maria V. Markovtseva, e-mail:

doi 10.18620/ctt-1866-8836-2020-9-3-1-152



Chronic lymphocytic leukemia (CLL) is one of the most common conditions in the group of lymphoproliferative diseases, occurring mainly in elderly patients. Patients in this group usually have concomitant diseases, which require an objective assessment of their comorbidities. Charlson comorbidity index (CCI) is one of the scales for evaluating the prognosis of patients with long follow-up terms. This parameter is a system of scoring age and a number of chronic comorbidities, including CLL. The aim of the study was to assess applicability of CCI in survival prediction of CLL patients.

Patients and methods

Clinical data from 155 patients (70 women and 85 men) with CLL A-C stage by Binet classification were retrospectively analyzed. CCI was calculated at the time of CLL diagnosis, the co-morbidity structure was evaluated, and the predicted survival time for this scale was compared with actual survival of the patients. The patients with HIV infection and other oncological conditions were excluded from the study.


The patients’ age was 69.7±9.4 years (males, 69.4±10.6 years; women, 70.2±7.4 years). Their mean CCI was 5.05±1.1 (6.3±1.4 for men, and 6.08±1.5 for women). The following structure of comorbid pathology was revealed: chronic kidney disease (CKD), 97.4% (n=151); chronic heart failure (CHF) 76.7% (n=115); arterial hypertension disease (HD), 66.4% (n=103); coronary heart disease (CHD), 63.2% (n=98); chronic non-specific lung diseases, 38% (n=59); liver and biliary tract diseases 35.4% (n=55); stomach and pancreatic diseases, 20% (n=31); diabetes mellitus, 7.7% (n=12). Worth of note, the glomerular filtration rate (GFR) was almost totally decreased among the studied patients. Upon assessing the CKD severity, stage C2 was mainly represented (61%, n=92). Stage C3a was diagnosed in 34.4% (n=52), stage C3b was confirmed in 4.6% (n=7). It is well known that the GFR decrease is known to be associated with worsening of long-term prognosis. It occurs among the elderly in general population, which mainly includes the studied patient cohort. In addition, the patients had comorbid conditions that comprise the so-called cardio-renal continuum (CHF, HD, CHD, diabetes). The paraneoplastic process itself also negatively affects the kidney function. A number of mediators produced by tumor tissue and immunocompetent cells in response to its growth may cause development of the paraneoplastic glomerulonephritis. In sum, all these factors inhibit kidney function, as shown by our study. Table 1 shows the estimated 10-year survival rate according to CCI and the actual CLL patients survival rate. Hence, the estimated 10-year survival rate according to CCI was achieved in 3.9% of the CLL patients (6 cases) only.

Table 1. Comparative characteristics of the predicted 10-year CLL patients survival rate according to Charlson comorbidity index and the actual survival rate



CLL patients have a fairly diverse comorbid pathology reproducing the general population somatic diseases prevalence: cardiovascular system diseases, chronic non-specific lung diseases, as well as gastrointestinal tract diseases. However, an important feature of the studied CLL patients is that CKD is the leader among all comorbid conditions. More than 97% of patients had this pathology. A comparative assessment of the estimated 10-year survival rate according to CCI and the actual patients survival rate showed that this parameter is ineffective for prediction. Despite the fact that CCI calculation takes into account not only CLL, but also other comorbid pathology, this parameter does not reflect the actual survival situation in CLL patient.


Chronic lymphocytic leukemia, Charlson comorbidity index, chronic kidney disease, survival rate.

Volume 9, Number 3

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doi 10.18620/ctt-1866-8836-2020-9-3-1-152

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