HEFT Repository

Primary care management of early stage chronic lymphocytic leukaemia is safe and effective.

Parry, H M and Damery, S and Mudondo, N P and Hazlewood, P and McSkeane, T and Aung, S and Murray, J and Pratt, G and Moss, P and Milligan, D W (2015) Primary care management of early stage chronic lymphocytic leukaemia is safe and effective. QJM : monthly journal of the Association of Physicians. ISSN 1460-2393.

Full text not available from this repository.
Official URL: http://qjmed.oxfordjournals.org/content/early/2015...

Abstract

BACKGROUND

Chronic lymphocytic leukaemia (CLL) is the commonest leukaemia in western society. Most patients are detected incidentally at an early stage and require 'watch and wait' follow-up. In the UK, management of Stage A0 CLL varies with some centres advising regular outpatient haematology follow-up, whereas others recommend management within primary care. The safety and effectiveness of these two management options are currently unknown.

METHODS

An observational retrospective cohort study in outpatient Haematology clinics at Queen Elizabeth Hospital Birmingham (QEH) and Birmingham Heartlands Hospital (BHH) and primary care practices in West Midlands, UK. All patients diagnosed with stable stage A0 CLL since 2002 at BHH or QEH were identified. At BHH, patients were discharged to primary care follow-up, whilst QEH patients remained under haematology for follow-up. Evidence of disease progression, need for treatment and overall mortality was documented.

RESULTS

Two hundred and forty-six Stage A0 CLL patients were identified. One hundred and five (43%) patients were discharged to primary care, whilst 141 (57%) patients were followed up in haematology outpatient clinics. No difference in mortality or need for treatment was found between the two groups. Of those discharged, 93 (66%) remained in primary care.

CONCLUSION

The management of stable-stage A0 CLL within primary or secondary care leads to equivalent clinical outcomes. The prevalence of early-stage CLL is expected to increase with the ageing population and management within primary care should be considered as a potentially effective approach.

Item Type: Article
Subjects: WH Haemic and lymphatic systems. Haematology
Divisions: Planned IP Care > Oncology and Clinical Haematology
Related URLs:
Depositing User: Miss Adele Stanton
Date Deposited: 31 May 2015 06:22
Last Modified: 31 May 2015 06:22
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/902

Actions (login required)

View Item View Item