James R. Cerhan, Tereza Sokolova, Elliott J. Cahn, Mazie Tsang, Christopher S. Strouse, Michelle A. T. Hildebrandt, Allison C. Rosenthal, Andrew L. Feldman, David L. Jaye, Peter Martin, Jonathon B. Cohen, Brad S. Kahl, Izidore S. Lossos, Jonathan W. Friedberg, Loretta J. Nastoupil, Brian K. Link, Thomas M. Habermann, Matthew J. Maurer, Carla Casulo, Carrie A. Thompson, Annalynn M. Williams, Christopher R. Flowers
{"title":"自我报告生成的Charlson合并症指数在淋巴瘤结局流行病学（LEO）队列中的适应和表现","authors":"James R. Cerhan, Tereza Sokolova, Elliott J. Cahn, Mazie Tsang, Christopher S. Strouse, Michelle A. T. Hildebrandt, Allison C. Rosenthal, Andrew L. Feldman, David L. Jaye, Peter Martin, Jonathon B. Cohen, Brad S. Kahl, Izidore S. Lossos, Jonathan W. Friedberg, Loretta J. Nastoupil, Brian K. Link, Thomas M. Habermann, Matthew J. Maurer, Carla Casulo, Carrie A. Thompson, Annalynn M. Williams, Christopher R. Flowers","doi":"10.1002/hon.70137","DOIUrl":null,"url":null,"abstract":"<div>\n \n <p>Newly diagnosed patients with non-Hodgkin lymphoma (NHL) often have a history of other diseases, and these comorbidities can impact patient treatment and management options, as well as overall survival (OS). We developed the Lymphoma Epidemiology of Outcomes (LEO) comorbidity index (LCI) as a sum of 10 comorbidities adapted from the Self-Report-Generated Charlson Comorbidity Index (SRG-CCI) for use in the LEO cohort, a national prospective study of newly diagnosed NHL. Of the 5502 participants with self-reported comorbidity data, 3107 (56.4%) were male and the mean age at diagnosis was 60.9 years (range, 18–99 years). The LCI ranged from 0 to 6, with 48.6% having 0, 30.2% having 1, 21.2% having 2 or more comorbidities. With a median follow-up of 62.4 months among surviving participants, 2099 patients had an event and 1219 died. Continuous LCI similarly predicted both 1-year mortality (c-statistic = 0.654) and OS (c-statistic = 0.655), while it showed a weaker but still statistically significant predictive ability for lymphoma-specific (c-statistics = 0.617) and event-free (c-statistic = 0.574) survival. Participants with 1 (HR = 1.21, 95% CI 1.05–1.39) and 2+ (HR = 1.80, 95% CI 1.56–2.08) comorbidities had inferior OS compared to those with no comorbidities after adjustment for age and sex (c-statistic = 0.654), and performance strengthened after adjustment for the International Prognostic Index (c-statistic = 0.672). LCI predicted OS most strongly in marginal zone (c-statistics = 0.748) and weakest in T-cell (c-statistic = 0.579) lymphoma. The cumulative incidence of death due to lymphoma, lymphoma treatment, and other causes all increased with increasing comorbidities, with the greatest increase observed for death due to other causes. The LCI performs comparable to other published comorbidity indices, supporting its use in the LEO cohort to better model real-world outcomes and more generally providing an approach to implementing comorbidity indices in cancer survivorship cohorts.</p>\n </div>","PeriodicalId":12882,"journal":{"name":"Hematological Oncology","volume":"43 6","pages":""},"PeriodicalIF":3.9000,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Adaptation and Performance of the Self-Report-Generated Charlson Comorbidity Index in the Lymphoma Epidemiology of Outcomes (LEO) Cohort\",\"authors\":\"James R. Cerhan, Tereza Sokolova, Elliott J. Cahn, Mazie Tsang, Christopher S. Strouse, Michelle A. T. Hildebrandt, Allison C. Rosenthal, Andrew L. Feldman, David L. Jaye, Peter Martin, Jonathon B. Cohen, Brad S. Kahl, Izidore S. Lossos, Jonathan W. Friedberg, Loretta J. Nastoupil, Brian K. Link, Thomas M. Habermann, Matthew J. Maurer, Carla Casulo, Carrie A. Thompson, Annalynn M. Williams, Christopher R. Flowers\",\"doi\":\"10.1002/hon.70137\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n <p>Newly diagnosed patients with non-Hodgkin lymphoma (NHL) often have a history of other diseases, and these comorbidities can impact patient treatment and management options, as well as overall survival (OS). We developed the Lymphoma Epidemiology of Outcomes (LEO) comorbidity index (LCI) as a sum of 10 comorbidities adapted from the Self-Report-Generated Charlson Comorbidity Index (SRG-CCI) for use in the LEO cohort, a national prospective study of newly diagnosed NHL. Of the 5502 participants with self-reported comorbidity data, 3107 (56.4%) were male and the mean age at diagnosis was 60.9 years (range, 18–99 years). The LCI ranged from 0 to 6, with 48.6% having 0, 30.2% having 1, 21.2% having 2 or more comorbidities. With a median follow-up of 62.4 months among surviving participants, 2099 patients had an event and 1219 died. Continuous LCI similarly predicted both 1-year mortality (c-statistic = 0.654) and OS (c-statistic = 0.655), while it showed a weaker but still statistically significant predictive ability for lymphoma-specific (c-statistics = 0.617) and event-free (c-statistic = 0.574) survival. Participants with 1 (HR = 1.21, 95% CI 1.05–1.39) and 2+ (HR = 1.80, 95% CI 1.56–2.08) comorbidities had inferior OS compared to those with no comorbidities after adjustment for age and sex (c-statistic = 0.654), and performance strengthened after adjustment for the International Prognostic Index (c-statistic = 0.672). LCI predicted OS most strongly in marginal zone (c-statistics = 0.748) and weakest in T-cell (c-statistic = 0.579) lymphoma. The cumulative incidence of death due to lymphoma, lymphoma treatment, and other causes all increased with increasing comorbidities, with the greatest increase observed for death due to other causes. The LCI performs comparable to other published comorbidity indices, supporting its use in the LEO cohort to better model real-world outcomes and more generally providing an approach to implementing comorbidity indices in cancer survivorship cohorts.</p>\\n </div>\",\"PeriodicalId\":12882,\"journal\":{\"name\":\"Hematological Oncology\",\"volume\":\"43 6\",\"pages\":\"\"},\"PeriodicalIF\":3.9000,\"publicationDate\":\"2025-10-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Hematological Oncology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/hon.70137\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"HEMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Hematological Oncology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/hon.70137","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEMATOLOGY","Score":null,"Total":0}
Adaptation and Performance of the Self-Report-Generated Charlson Comorbidity Index in the Lymphoma Epidemiology of Outcomes (LEO) Cohort
Newly diagnosed patients with non-Hodgkin lymphoma (NHL) often have a history of other diseases, and these comorbidities can impact patient treatment and management options, as well as overall survival (OS). We developed the Lymphoma Epidemiology of Outcomes (LEO) comorbidity index (LCI) as a sum of 10 comorbidities adapted from the Self-Report-Generated Charlson Comorbidity Index (SRG-CCI) for use in the LEO cohort, a national prospective study of newly diagnosed NHL. Of the 5502 participants with self-reported comorbidity data, 3107 (56.4%) were male and the mean age at diagnosis was 60.9 years (range, 18–99 years). The LCI ranged from 0 to 6, with 48.6% having 0, 30.2% having 1, 21.2% having 2 or more comorbidities. With a median follow-up of 62.4 months among surviving participants, 2099 patients had an event and 1219 died. Continuous LCI similarly predicted both 1-year mortality (c-statistic = 0.654) and OS (c-statistic = 0.655), while it showed a weaker but still statistically significant predictive ability for lymphoma-specific (c-statistics = 0.617) and event-free (c-statistic = 0.574) survival. Participants with 1 (HR = 1.21, 95% CI 1.05–1.39) and 2+ (HR = 1.80, 95% CI 1.56–2.08) comorbidities had inferior OS compared to those with no comorbidities after adjustment for age and sex (c-statistic = 0.654), and performance strengthened after adjustment for the International Prognostic Index (c-statistic = 0.672). LCI predicted OS most strongly in marginal zone (c-statistics = 0.748) and weakest in T-cell (c-statistic = 0.579) lymphoma. The cumulative incidence of death due to lymphoma, lymphoma treatment, and other causes all increased with increasing comorbidities, with the greatest increase observed for death due to other causes. The LCI performs comparable to other published comorbidity indices, supporting its use in the LEO cohort to better model real-world outcomes and more generally providing an approach to implementing comorbidity indices in cancer survivorship cohorts.
期刊介绍：
Hematological Oncology considers for publication articles dealing with experimental and clinical aspects of neoplastic diseases of the hemopoietic and lymphoid systems and relevant related matters. Translational studies applying basic science to clinical issues are particularly welcomed. Manuscripts dealing with the following areas are encouraged:
-Clinical practice and management of hematological neoplasia, including: acute and chronic leukemias, malignant lymphomas, myeloproliferative disorders
-Diagnostic investigations, including imaging and laboratory assays
-Epidemiology, pathology and pathobiology of hematological neoplasia of hematological diseases
-Therapeutic issues including Phase 1, 2 or 3 trials as well as allogeneic and autologous stem cell transplantation studies
-Aspects of the cell biology, molecular biology, molecular genetics and cytogenetics of normal or diseased hematopoeisis and lymphopoiesis, including stem cells and cytokines and other regulatory systems.
Concise, topical review material is welcomed, especially if it makes new concepts and ideas accessible to a wider community. Proposals for review material may be discussed with the Editor-in-Chief. Collections of case material and case reports will be considered only if they have broader scientific or clinical relevance.
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