Journal article
Assessing the value of measuring frailty in patients with chronic lymphocytic leukemia/small lymphocytic lymphoma
Leukemia research, Vol.166, 108238
04/28/2026
DOI: 10.1016/j.leukres.2026.108238
PMID: 42066411
Abstract
Most patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) have comorbidities at diagnosis, which are associated with worse outcomes. Despite its clinical relevance, frailty is understudied in CLL/SLL. Our study examined the contributions of frailty, measured with Function-Related Indicators (FRIs), and comorbidity for assessing health status in patients with newly diagnosed CLL/SLL.
Using Surveillance, Epidemiology, and End Results-Medicare data, we identified 30,880 older patients with CLL/SLL. FRI score and the National Cancer Institute (NCI) Comorbidity Index were calculated using claims in the year before diagnosis. Hazard ratios (HRs) for mortality and hospitalization were assessed with Cox hazards models.
Frailty and comorbidity were common prior to diagnosis: 48.6% of patients had ≥1 FRI, 64.8% had ≥1 condition in the NCI Comorbidity Index, and 27.4% had prior or simultaneous cancer. People with more FRIs (i.e., frailer) were older, more likely to be female and unmarried, had more comorbidities, and were more likely to have been hospitalized in the 12-months prior to CLL/SLL diagnosis. The FRI remained predictive after adjusting for comorbidity and patients with higher baseline frailty had an increased risk of mortality (FRI ≥2 vs 0: adjusted HR = 1.37, 95% CI: 1.31-1.43) and hospitalization (FRI ≥2 vs 0: adjusted HR = 1.34, 95% CI: 1.29-1.40).
Different aspects of health status were identified by the FRI and comorbidity. Assessing frailty at diagnosis, when many patients have not yet experienced extensive disease-related symptoms, adds independently to predicting patient outcomes beyond comorbidity alone.
•Frailty was common at diagnosis among older patients with CLL/SLL.•Frailer patients had more comorbidity and increased risk of poor health outcomes.•The FRIs also measure health complexity independent of comorbidity.
Details
- Title: Subtitle
- Assessing the value of measuring frailty in patients with chronic lymphocytic leukemia/small lymphocytic lymphoma
- Creators
- Vanessa E. Slater - University of IowaBradley D. McDowell - University of IowaElizabeth A. Chrischilles - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Leukemia research, Vol.166, 108238
- DOI
- 10.1016/j.leukres.2026.108238
- PMID
- 42066411
- ISSN
- 0145-2126
- eISSN
- 1873-5835
- Publisher
- Elsevier Ltd
- Grant note
- Holden Comprehensive Cancer Center at the University of Iowa National Cancer Institute: P30 CA086862 California Department of Public Health: 103885 Centers for Disease Control and Prevention's (CDC) National Program of Cancer Registries: 1NU58DP007156 National Cancer Institute's Surveillance, Epidemiology and End Results Program: HHSN2612018000321 University of California, San Francisco: HHSN2612018000151 University of Southern California: HHSN2612018000091
This work was supported in part by resources from the Holden Comprehensive Cancer Center at the University of Iowa, supported by the National Cancer Institute (P30 CA086862) . This study used the linked SEER-Medicare database. The interpretation and reporting of these data are the sole responsibility of the authors. The authors acknowledge the efforts of the National Cancer Institute; Information Management Services (IMS) , Inc.; and the Surveillance, Epidemiology, and End Results (SEER) Program tumor registries in the creation of the SEER-Medicare database. The collection of cancer incidence data used in this study was supported by the California Department of Public Health pursuant to California Health and Safety Code Section 103885; Centers for Disease Control and Prevention's (CDC) National Program of Cancer Registries, under cooperative agreement 1NU58DP007156; the National Cancer Institute's Surveillance, Epidemiology and End Results Program under contract HHSN2612018000321 awarded to the University of California, San Francisco, contract HHSN2612018000151 awarded to the University of Southern California, and contract HHSN2612018000091 awarded to the Public Health Institute. The ideas and opinions expressed herein are those of the author (s) and do not necessarily reflect the opinions of the State of California, Department of Public Health, the National Cancer Institute, and the Centers for Disease Control and Prevention or their Contractors and Subcontractors.
- Language
- English
- Date published
- 04/28/2026
- Academic Unit
- Pharmacy; Epidemiology; Holden Comprehensive Cancer Center
- Record Identifier
- 9985157606902771
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