Contribution of social and demographic parameters to the long-term survival prognosis of chronic myeloid leukemia patients

Abstract

Introduction. Therapy of chronic myeloid leukemia (CML) for the majority of patients is associated with continuous lifelong drug intake. Irregular drug intake greatly increases the risk of CML progression and death. It is still not well understood to what extent social and demographic factors infl uence the long-term consequences of CML therapy.Aim — to determine the prognostic value of social parameters like marital status and education level in comparison with standard risk factors for the course of the disease.Materials and methods. A multifactorial data analysis of the presented sociodemographic parameters was carried out on a cohort of CML patients included in the multicenter observational study “Russian Registry for the Treatment of Chronic Myeloid Leukemia in Routine Clinical Practice”. The database of the study conducted in Russia in 2011–2016 includes records of 12160 patients with CML. To analyze the register data, we used classical methods of event analysis implemented in the SAS 9.4 package.Results. A large volume of data with a high level of signifi cance showed that educational level and marital status have a great prognostic value in assessing the long-term results of therapy in patients with CML, comparable to known risk factors. The contribution of these signs was evaluated and analyzed taking into account such known factors as age, ELTS index, and region or clinic where the patient was observed and treated. Thus, low educational qualifi cations and marital status “divorced” or “widowed” demonstrated signifi cant and independent risk factors that negatively affect the life expectancy of patients with CML Conclusion. The discovered phenomenon is key in long-term survival and can be explained by the indirect infl uence of social-demographic parameters through adherence behavior of CML patients. Higher level of education proved to be a favorable factor while a widowed/divorced marital status was found to be an unfavorable factor of OS prognosis. General clinic, age related interpretations, and regional features were also tested and did not fi nd any confi rmation.