THE ASSOCIATION OF DYSLIPIDEMIA WITH CHRONIC LYMPHOCYTIC LEUKEMIA: A POPULATION-BASED STUDY
(Abstract release date: 05/19/16)
EHA Library. Mozessohn L. 06/09/16; 132615; E1066
Dr. Lee Mozessohn
Contributions
Contributions
Abstract
Abstract: E1066
Type: Eposter Presentation
Background
Metabolic syndrome (MetS) is a risk factor for the development of cancer. In addition, pre-clinical data suggest that chronic lymphocytic leukemia (CLL) cells are dependent on adipocytes and fatty acids for growth and that aberrant lipid metabolism is an important pathogenic mechanism in CLL.
Aims
Our objective was to determine whether patients with CLL have a higher incidence of MetS prior to their CLL diagnosis compared to those without CLL and to determine the impact of lipid-lowering medications on survival.
Methods
We conducted a population-based retrospective cohort study in Ontario, Canada using administrative databases of adults >66 years old to compare the prevalence of MetS and its components (diabetes, dyslipidemia, hypertension) before a diagnosis of CLL compared to age and sex-matched controls without CLL. Logistic regression was used to study the association between MetS and its components to CLL. The Kaplan-Meier method and Cox Regression were used to investigate survival.
Results
We identified 2124 persons with CLL and 7935 controls from January 1, 2000 to December 31, 2005 with follow-up until death or March 31, 2014. The median follow-up was 10.7 years (95% CI, 10.5 to 10.9). Overall, the mean age was 75.6 years and 42.1% were female, 20.2% had diabetes, 35.8% had hypertension, 17.6% had dyslipidemia and 28.0% received lipid-lowering medications prior to a diagnosis of CLL. In multivariable analysis, dyslipidemia (OR 1.34, 95% CI 1.17 to 1.54) and hypertension (OR 1.20, 95% CI 1.07 to 1.34) were associated with the development of CLL, whereas MetS and diabetes alone were not.On univariable survival analysis, dyslipidemia in CLL patients was associated with a significantly worse overall survival, however, not on multivariable analysis (HR 1.06, 95% CI 0.91 to 1.23). In comparison, lipid-lowering medication use at any time was associated with a significantly improved overall survival on univariable (see Figure) and multivariable analysis (HR 0.55, 95% CI 0.49 to 0.63) as was female sex (HR 0.66, 95% CI 0.59 to 0.75) and fewer comorbidities (HR 0.72, 95% CI 0.59 to 0.89). Advanced age (HR 1.08, 95% CI 1.06 to 1.09) and diabetes (HR 1.31, 95% CI 1.14 to 1.50) were associated with a significantly worse overall survival.
Conclusion
We demonstrate an association between dyslipidemia and the development of CLL, supporting pre-clinical data. Furthermore, the relationship is independent of metabolic syndrome and diabetes. Lipid-lowering medications appear to confer a survival advantage in CLL. Prospective studies are needed to confirm these results and test their potential application to intervention strategies.
Session topic: E-poster
Keyword(s): Chronic lymphocytic leukemia, Comorbidities, Epidemiology, Statin
Type: Eposter Presentation
Background
Metabolic syndrome (MetS) is a risk factor for the development of cancer. In addition, pre-clinical data suggest that chronic lymphocytic leukemia (CLL) cells are dependent on adipocytes and fatty acids for growth and that aberrant lipid metabolism is an important pathogenic mechanism in CLL.
Aims
Our objective was to determine whether patients with CLL have a higher incidence of MetS prior to their CLL diagnosis compared to those without CLL and to determine the impact of lipid-lowering medications on survival.
Methods
We conducted a population-based retrospective cohort study in Ontario, Canada using administrative databases of adults >66 years old to compare the prevalence of MetS and its components (diabetes, dyslipidemia, hypertension) before a diagnosis of CLL compared to age and sex-matched controls without CLL. Logistic regression was used to study the association between MetS and its components to CLL. The Kaplan-Meier method and Cox Regression were used to investigate survival.
Results
We identified 2124 persons with CLL and 7935 controls from January 1, 2000 to December 31, 2005 with follow-up until death or March 31, 2014. The median follow-up was 10.7 years (95% CI, 10.5 to 10.9). Overall, the mean age was 75.6 years and 42.1% were female, 20.2% had diabetes, 35.8% had hypertension, 17.6% had dyslipidemia and 28.0% received lipid-lowering medications prior to a diagnosis of CLL. In multivariable analysis, dyslipidemia (OR 1.34, 95% CI 1.17 to 1.54) and hypertension (OR 1.20, 95% CI 1.07 to 1.34) were associated with the development of CLL, whereas MetS and diabetes alone were not.On univariable survival analysis, dyslipidemia in CLL patients was associated with a significantly worse overall survival, however, not on multivariable analysis (HR 1.06, 95% CI 0.91 to 1.23). In comparison, lipid-lowering medication use at any time was associated with a significantly improved overall survival on univariable (see Figure) and multivariable analysis (HR 0.55, 95% CI 0.49 to 0.63) as was female sex (HR 0.66, 95% CI 0.59 to 0.75) and fewer comorbidities (HR 0.72, 95% CI 0.59 to 0.89). Advanced age (HR 1.08, 95% CI 1.06 to 1.09) and diabetes (HR 1.31, 95% CI 1.14 to 1.50) were associated with a significantly worse overall survival.
Conclusion
We demonstrate an association between dyslipidemia and the development of CLL, supporting pre-clinical data. Furthermore, the relationship is independent of metabolic syndrome and diabetes. Lipid-lowering medications appear to confer a survival advantage in CLL. Prospective studies are needed to confirm these results and test their potential application to intervention strategies.
Session topic: E-poster
Keyword(s): Chronic lymphocytic leukemia, Comorbidities, Epidemiology, Statin
Abstract: E1066
Type: Eposter Presentation
Background
Metabolic syndrome (MetS) is a risk factor for the development of cancer. In addition, pre-clinical data suggest that chronic lymphocytic leukemia (CLL) cells are dependent on adipocytes and fatty acids for growth and that aberrant lipid metabolism is an important pathogenic mechanism in CLL.
Aims
Our objective was to determine whether patients with CLL have a higher incidence of MetS prior to their CLL diagnosis compared to those without CLL and to determine the impact of lipid-lowering medications on survival.
Methods
We conducted a population-based retrospective cohort study in Ontario, Canada using administrative databases of adults >66 years old to compare the prevalence of MetS and its components (diabetes, dyslipidemia, hypertension) before a diagnosis of CLL compared to age and sex-matched controls without CLL. Logistic regression was used to study the association between MetS and its components to CLL. The Kaplan-Meier method and Cox Regression were used to investigate survival.
Results
We identified 2124 persons with CLL and 7935 controls from January 1, 2000 to December 31, 2005 with follow-up until death or March 31, 2014. The median follow-up was 10.7 years (95% CI, 10.5 to 10.9). Overall, the mean age was 75.6 years and 42.1% were female, 20.2% had diabetes, 35.8% had hypertension, 17.6% had dyslipidemia and 28.0% received lipid-lowering medications prior to a diagnosis of CLL. In multivariable analysis, dyslipidemia (OR 1.34, 95% CI 1.17 to 1.54) and hypertension (OR 1.20, 95% CI 1.07 to 1.34) were associated with the development of CLL, whereas MetS and diabetes alone were not.On univariable survival analysis, dyslipidemia in CLL patients was associated with a significantly worse overall survival, however, not on multivariable analysis (HR 1.06, 95% CI 0.91 to 1.23). In comparison, lipid-lowering medication use at any time was associated with a significantly improved overall survival on univariable (see Figure) and multivariable analysis (HR 0.55, 95% CI 0.49 to 0.63) as was female sex (HR 0.66, 95% CI 0.59 to 0.75) and fewer comorbidities (HR 0.72, 95% CI 0.59 to 0.89). Advanced age (HR 1.08, 95% CI 1.06 to 1.09) and diabetes (HR 1.31, 95% CI 1.14 to 1.50) were associated with a significantly worse overall survival.
Conclusion
We demonstrate an association between dyslipidemia and the development of CLL, supporting pre-clinical data. Furthermore, the relationship is independent of metabolic syndrome and diabetes. Lipid-lowering medications appear to confer a survival advantage in CLL. Prospective studies are needed to confirm these results and test their potential application to intervention strategies.
Session topic: E-poster
Keyword(s): Chronic lymphocytic leukemia, Comorbidities, Epidemiology, Statin
Type: Eposter Presentation
Background
Metabolic syndrome (MetS) is a risk factor for the development of cancer. In addition, pre-clinical data suggest that chronic lymphocytic leukemia (CLL) cells are dependent on adipocytes and fatty acids for growth and that aberrant lipid metabolism is an important pathogenic mechanism in CLL.
Aims
Our objective was to determine whether patients with CLL have a higher incidence of MetS prior to their CLL diagnosis compared to those without CLL and to determine the impact of lipid-lowering medications on survival.
Methods
We conducted a population-based retrospective cohort study in Ontario, Canada using administrative databases of adults >66 years old to compare the prevalence of MetS and its components (diabetes, dyslipidemia, hypertension) before a diagnosis of CLL compared to age and sex-matched controls without CLL. Logistic regression was used to study the association between MetS and its components to CLL. The Kaplan-Meier method and Cox Regression were used to investigate survival.
Results
We identified 2124 persons with CLL and 7935 controls from January 1, 2000 to December 31, 2005 with follow-up until death or March 31, 2014. The median follow-up was 10.7 years (95% CI, 10.5 to 10.9). Overall, the mean age was 75.6 years and 42.1% were female, 20.2% had diabetes, 35.8% had hypertension, 17.6% had dyslipidemia and 28.0% received lipid-lowering medications prior to a diagnosis of CLL. In multivariable analysis, dyslipidemia (OR 1.34, 95% CI 1.17 to 1.54) and hypertension (OR 1.20, 95% CI 1.07 to 1.34) were associated with the development of CLL, whereas MetS and diabetes alone were not.On univariable survival analysis, dyslipidemia in CLL patients was associated with a significantly worse overall survival, however, not on multivariable analysis (HR 1.06, 95% CI 0.91 to 1.23). In comparison, lipid-lowering medication use at any time was associated with a significantly improved overall survival on univariable (see Figure) and multivariable analysis (HR 0.55, 95% CI 0.49 to 0.63) as was female sex (HR 0.66, 95% CI 0.59 to 0.75) and fewer comorbidities (HR 0.72, 95% CI 0.59 to 0.89). Advanced age (HR 1.08, 95% CI 1.06 to 1.09) and diabetes (HR 1.31, 95% CI 1.14 to 1.50) were associated with a significantly worse overall survival.
Conclusion
We demonstrate an association between dyslipidemia and the development of CLL, supporting pre-clinical data. Furthermore, the relationship is independent of metabolic syndrome and diabetes. Lipid-lowering medications appear to confer a survival advantage in CLL. Prospective studies are needed to confirm these results and test their potential application to intervention strategies.
Session topic: E-poster
Keyword(s): Chronic lymphocytic leukemia, Comorbidities, Epidemiology, Statin
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