{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T02:19:52Z","timestamp":1785550792612,"version":"3.56.0"},"reference-count":37,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,1,28]],"date-time":"2025-01-28T00:00:00Z","timestamp":1738022400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100020869","name":"AstraZeneca KK","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100020869","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Due to its rarity, there are very limited data available on the cause of death (COD) and its association with comorbidities in Japanese chronic lymphocytic leukemia (CLL) patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>To investigate the prevalence of comorbidities and their impact on cause\u2010specific mortality, we retrospectively reviewed 121 Japanese patients with CLL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median age was 69\u2009years, with 47.9% having at least one comorbidity listed in the Charlson Comorbidity Index (CCI), and 12.4% were multimorbid. With a median follow\u2010up of 74\u2009months, the 5\u2010 and 10\u2010year overall survival rates were 80.6% and 60.1%, respectively. Among the 44 deaths observed, CLL progression was the leading COD (38.6%), which together with infections and other malignancies accounted for nearly 80%. Patients with higher CCI risk categories had significantly higher 5\u2010year all\u2010cause mortality (CCI 1\u20132: 22.9% and \u2265\u20093: 31.4%) and non\u2010CLL\u2010specific mortality (CCI 1\u20132: 18.8% and \u2265\u20093: 31.4%) compared to those without (CCI 0: 12.6%, <jats:italic>p<\/jats:italic>\u2009=\u20090.005; 3.5%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001, respectively), whereas CLL\u2010specific mortality was not influenced. On multivariate analysis, age and CCI retained a significant prognostic impact on all\u2010cause mortality (hazard ratio [HR] 1.08, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001 and HR 1.88, <jats:italic>p<\/jats:italic>\u2009=\u20090.004, respectively) and non\u2010CLL\u2010specific mortality (HR 1.12, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001 and HR 3.81, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our study showed that CLL itself was the leading COD, and comorbidity burden was associated with non\u2010CLL\u2010specific deaths. This highlights the importance of better disease control and effective management of comorbidities.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.70613","type":"journal-article","created":{"date-parts":[[2025,1,28]],"date-time":"2025-01-28T10:40:24Z","timestamp":1738060824000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Cause\u2010Specific Mortality and Prognostic Impact of Comorbidity in Japanese Patients With Chronic Lymphocytic Leukemia"],"prefix":"10.1002","volume":"14","author":[{"given":"Daisuke","family":"Ikeda","sequence":"first","affiliation":[{"name":"Division of Hematology\/Oncology, Department of Internal Medicine Kameda Medical Center  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1591-1454","authenticated-orcid":false,"given":"Takuya","family":"Nunomura","sequence":"additional","affiliation":[{"name":"Department of Hematology Hiroshima Red Cross Hospital and Atomic\u2010Bomb Survivors Hospital  Hiroshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsuyoshi","family":"Muta","sequence":"additional","affiliation":[{"name":"Department of Hematology Hiroshima Red Cross Hospital and Atomic\u2010Bomb Survivors Hospital  Hiroshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8669-9865","authenticated-orcid":false,"given":"Kosei","family":"Matsue","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology, Department of Internal Medicine Kameda Medical Center  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,1,28]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41408-022-00756-9"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(16)30029-8"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2023022564"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.12659"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2015-03-567388"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.14785"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-021-01156-x"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/10428190701724785"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2013.096792"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2017-09-806398"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.publhealth.20.1.145"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tranon.2021.101176"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12185-024-03741-z"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2017-11-818286"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers16061228"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2016.157552"},{"issue":"12","key":"e_1_2_11_19_1","article-title":"Distinct Immunogenetic Profiles of Chronic Lymphocytic Leukemia in Asia: A Taiwan Cooperative Oncology Group Registry Study","volume":"6","author":"Yao C. 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