1. Limited value of routine follow-up visits in chronic lymphocytic leukemia managed initially by watch and wait: A North Denmark population-based study.
- Author
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Nørgaard, Caroline Holm, Søgaard, Nikoline Buus, Biccler, Jorne Lionel, Pilgaard, Laura, Eskesen, Mathias Holmsgaard, Kjartansdottir, Thordis Helga, Bøgsted, Martin, and El-Galaly, Tarec Christoffer
- Subjects
LYMPHOCYTIC leukemia ,CYTOGENETICS ,MEDICAL practice ,LOGISTIC regression analysis ,FOLLOW-up studies (Medicine) - Abstract
Introduction: The majority of newly diagnosed chronic lymphocytic leukemia (CLL) patients are followed initially by watch and wait (WAW). Clinical practice varies and the value of frequent follow-up visits remains unclear. Thus, in this study we investigated the clinical value of follow-up visits for patients with CLL. Methods: We collected data from diagnosis and follow-up visits for patients diagnosed with CLL and managed by WAW in the North Denmark Region between 2007–2014. High- and low-risk group patients were determined by Binet stage, IgVH status, and cytogenetics at diagnosis. The effect of risk group allocation on the probability of receiving CLL-directed treatment within two years was included in a multivariable logistic regression model adjusted for age and blood test results. Results: 273 patients were included in the study with a median follow-up of 3 years (IQR: 1.6–5.4). Overall, the median interval between follow-up visits was 98 days (95% CI: 96–100) (high-risk patients: 91 days [95% CI: 86–95] vs. low-risk patients: 105 days [95% CI: 100–110]). Among 2,312 follow-up visits, only 387 (17%) were associated with interventions. At the following time points: 6 months, 1 year, and 1.5 years, patients with low-risk CLL had significantly lower odds of initiating treatment compared to patients with high-risk CLL. Conclusion: WAW plays an important role in managing CLL. Interventions at follow-up visits were infrequent and low-risk patients had significantly lower risk of treatment initiation. We question the value of routine follow-up in CLL in the absence of changes in symptoms and/or blood test results. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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