According to a press release published in MedicalXpress, a recent study of patients in Denmark living with slow-growing, low risk chronic lymphocytic leukemia (CLL) suggested that these individuals didn’t see any meaningful benefit from specialist follow-up in a three-year period, and in fact, may be better off without it.
About The Study
When compared to patients who attended specialized follow-up appointments, patients that stopped going saw fewer infections, fewer hospital visits, and a comparable rate of survival. In the study, 84% of the patients never experienced any signs of disease progression; as a result, they were never referred to a hematologist during the three-year study period.
This form of leukemia has both an aggressive form, which requires prompt treatment, and an indolent form, which progresses very slowly and can stay practically unchanged for years at a time. Research suggests that as many as three of every ten patients never need treatment; regardless, these patients undergo specialty surveillance called ‘watchful waiting.’ While some patients appreciate this approach, they must undergo blood tests and exams that can inflict unnecessary stress.
The study included 200 patients and the team selected 112 of them who they deemed sufficiently low risk to cease specialty follow-up. These patients were told to receive flu and pneumonia vaccines and to contact their doctor only if they developed symptoms of cancer or infection. The principal endpoint was overall survival at three years.
14 patients who discontinued follow-up died, compared to 19 patient deaths in the group that continued specialty follow-up. 45% of the discontinued patients had infections that required antibiotic treatment, compared to 51% of the others who continued to receive specialty follow-up.
Overall, the researchers concluded that low-risk chronic lymphocytic leukemia patients may not need specialty-follow up. The researchers did acknowledge some weaknesses of the study, as it was not randomized, with the team selecting patients who met specific low-risk guidelines. Additionally, the noted that the results may not apply in health systems based around private insurance, such as the US.
About Chronic Lymphocytic Leukemia (CLL)
Chronic lymphocytic leukemia is a form of blood cancer which affects lymphocytes, which are a type of white blood cell. The disease may not cause noticeable symptoms in its early stages. This cancer is linked to certain genetic mutations; notable risk factors for this blood cancer include old age, being male, exposure to certain insecticides, exposure to Agent Orange, and family history. Symptoms of chronic lymphocytic leukemia include fever, anemia, swollen lymph nodes, weight loss, and fatigue. It is also possible for this disease to transform into a more aggressive and faster progressing type of blood cancer like Hodgkin’s lymphoma. Treatment for this disease focuses mostly on controlling symptoms, and there is no cure. These treatments may include radiation therapy, chemotherapy, surgery, bone marrow transplant, or biological therapy. As a slow growing cancer, the five-year survival rate is 83 percent. To learn more about chronic lymphocytic leukemia, click here.
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Last modified: April 19, 2024
