Abstract

Abstract 2085

Introduction.

Although advanced patient age is commonly used as a factor in selecting therapy for patients with chronic lymphocytic leukemia (CLL), based on presumed associations with functional status, limited data exist regarding the relationships between age and physical, emotional, social, and functional well being. We examined the relationships between age and these domains of health-related quality of life (HRQOL) for CLL patients treated in US community practices.

Methods.

Baseline data were collected as part of Connect CLL®, a prospective observational registry initiated in March 2010 involving centers in the US. Data on patient demographics and clinical characteristics were provided by clinicians. HRQOL was self-reported by patients in the clinic at enrollment. Patients completed 3 psychometrically validated instruments: the Brief Fatigue Inventory (BFI), EQ-5D, and Functional Assessment of Cancer Therapy-Leukemia (FACT-Leu). Standard analyses were conducted of each instrument given clinical characteristics at that time. Reported mean BFI, EQ-5D and FACT-Leu scores were analyzed by age group (<65, 65–74, >74). Statistical significance of score differences among sub-cohorts was ascertained by ANOVA using SAS 9.1.

Results.

Baseline HRQOL data were reported by 604 patients, enrolled from 161 centers. Patients were predominantly male (62%) and white (90%) with mean age at 69.9 (standard deviation [SD] 11.2) yrs. HRQOL scores by age group are presented:

Baseline HRQOL by Age Group
HRQOL Scores Age <65 (n=197) Age 65–74 (n=185) Age >= 75 (n=222) P-value 
BFI Mean(SD)     
    Global 4.4 (2.5) 4.1 (2.3) 4.5 (2.5) 0.2738 
    Severity 4.9 (2.6) 4.9 (2.6) 5.3 (2.8) 0.1536 
    Interference 4.1 (2.6) 3.7 (2.4) 4.1 (2.6) 0.2795 
EQ-5D     
    VAS Scale Mean(SD) 71.4 (19.7) 71.4 (22.5) 68.6 (21.2) 0.3501 
    Mobility Mean(SD) 1.2 (0.4) 1.2 (0.4) 1.4 (0.5) <.0001 
    Self Care Mean(SD) 1.1 (0.2) 1.0 (0.2) 1.1 (0.3) 0.0724 
    Usual Activities Mean(SD) 1.4 (0.5) 1.3 (0.5) 1.5 (0.6) 0.0164 
    Pain/Discomfort Mean(SD) 1.4 (0.6) 1.3 (0.5) 1.6 (0.5) 0.0002 
    Anxiety/Depression Mean(SD) 1.3 (0.5) 1.3 (0.5) 1.3 (0.5) 0.7725 
FACT-LEU Mean(SD)     
    Physical 21.7 (5.2) 23.0 (4.2) 22.4 (4.5) 0.0365 
    Social/Family 23.2 (5.1) 23.7 (5.1) 23.3 (5.8) 0.7227 
    Emotional 18.6 (3.8) 19.3 (3.4) 19.3 (3.7) 0.1059 
    Functional 19.5 (5.7) 20.4 (6.0) 19.5 (6.3) 0.2185 
    CLL subscale Score 48.5 (10.6) 50.0 (9.6) 47.4 (10.6) 0.0634 
    FACT-G Total 83.0 (15.1) 86.5 (13.6) 84.5 (14.6) 0.0830 
    FACT-LEU Total 131.5 (23.5) 136.5 (20.7) 132.1 (22.7) 0.0846 
Baseline HRQOL by Age Group
HRQOL Scores Age <65 (n=197) Age 65–74 (n=185) Age >= 75 (n=222) P-value 
BFI Mean(SD)     
    Global 4.4 (2.5) 4.1 (2.3) 4.5 (2.5) 0.2738 
    Severity 4.9 (2.6) 4.9 (2.6) 5.3 (2.8) 0.1536 
    Interference 4.1 (2.6) 3.7 (2.4) 4.1 (2.6) 0.2795 
EQ-5D     
    VAS Scale Mean(SD) 71.4 (19.7) 71.4 (22.5) 68.6 (21.2) 0.3501 
    Mobility Mean(SD) 1.2 (0.4) 1.2 (0.4) 1.4 (0.5) <.0001 
    Self Care Mean(SD) 1.1 (0.2) 1.0 (0.2) 1.1 (0.3) 0.0724 
    Usual Activities Mean(SD) 1.4 (0.5) 1.3 (0.5) 1.5 (0.6) 0.0164 
    Pain/Discomfort Mean(SD) 1.4 (0.6) 1.3 (0.5) 1.6 (0.5) 0.0002 
    Anxiety/Depression Mean(SD) 1.3 (0.5) 1.3 (0.5) 1.3 (0.5) 0.7725 
FACT-LEU Mean(SD)     
    Physical 21.7 (5.2) 23.0 (4.2) 22.4 (4.5) 0.0365 
    Social/Family 23.2 (5.1) 23.7 (5.1) 23.3 (5.8) 0.7227 
    Emotional 18.6 (3.8) 19.3 (3.4) 19.3 (3.7) 0.1059 
    Functional 19.5 (5.7) 20.4 (6.0) 19.5 (6.3) 0.2185 
    CLL subscale Score 48.5 (10.6) 50.0 (9.6) 47.4 (10.6) 0.0634 
    FACT-G Total 83.0 (15.1) 86.5 (13.6) 84.5 (14.6) 0.0830 
    FACT-LEU Total 131.5 (23.5) 136.5 (20.7) 132.1 (22.7) 0.0846 

There were no significant differences between the age groups in fatigue as measured by the BFI, or differences in overall HRQOL as measured by the EQ-5D Visual Analogue Scale (VAS) or the FACT-G. Anxiety/depression and self care are EQ-5D domains that also did not vary by age. Although mobility was most impaired in the oldest age group compared to the two younger groups, usual activities and pain/discomfort were worse in both the younger and older cohorts compared to those 65–74 years of age. FACT-Leu results indicated that the social/family domain scores did not vary by age, but that physical, emotional, and functional domains did vary statistically with the oldest typically doing better than the 65–74 year olds, but not necessarily better than those <65.

Conclusions.

Initial results from the Connect CLL® Registry indicate that HRQOL does not worsen monotonically with older age. In this cohort, both the youngest and oldest age groups had worse HRQOL in certain domains, presenting an inverted v-shaped relationship. Future analyses should be conducted on: (1) how HRQOL may be affected over time with changes in disease; and, (2) how HRQOL may be influenced by alternative therapies. Results reported here should serve as a useful baseline reference.

Disclosures:

Pashos:Celgene: Membership on an entity's Board of Directors or advisory committees. Flowers:Genentech/Roche (unpaid): Consultancy; Celgene: Consultancy; Millennium/Takeda: Research Funding; Wyeth: Research Funding; Novartis: Research Funding. Weiss:Celgene: Membership on an entity's Board of Directors or advisory committees. Lamanna:Celgene: Membership on an entity's Board of Directors or advisory committees. Farber:Celgene: Membership on an entity's Board of Directors or advisory committees. Kipps:Igenica: Equity Ownership, Membership on an entity's Board of Directors or advisory committees; Celgene: Consultancy, Research Funding; Abbot Industries: Research Funding; Pharmacyclics: Membership on an entity's Board of Directors or advisory committees; Genentech: Research Funding; GSK: Research Funding; Gilead Sciences: Consultancy, Research Funding; Amgen: Research Funding. Lerner:Celgene: Membership on an entity's Board of Directors or advisory committees. Kay:Celgene: Membership on an entity's Board of Directors or advisory committees. Sharman:Celgene: Membership on an entity's Board of Directors or advisory committees. Grinblatt:Celgene: Membership on an entity's Board of Directors or advisory committees. Flinn:Celgene: Membership on an entity's Board of Directors or advisory committees. Kozloff:Celgene: Membership on an entity's Board of Directors or advisory committees. Swern:Celgene Corporation: Employment, Equity Ownership. Kahn:Celgene Corporation: Employment, Equity Ownership. Street:Celgene: Employment, Equity Ownership. Sullivan:Celgene: Employment, Equity Ownership. Keating:Celgene: Membership on an entity's Board of Directors or advisory committees.

Author notes

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Asterisk with author names denotes non-ASH members.