https://orcid.org/0000-0002-9338-997X
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Abstract
Purpose
Most adult patients diagnosed with acute lymphoblastic leukemia (ALL) are below retirement age. The overall survival of patients with ALL has improved with implementation of high intensity pediatric-inspired treatment protocols. However, this treatment comes with a risk of long-term complications, which could affect the ability to work. The aim of this study was to investigate the risk of disability pension (DP) and return to work (RTW) for patients with ALL.
Patients and Methods
Patients aged 18–60 years diagnosed with ALL between 2005 and 2019 were identified in the Danish National Acute Leukemia Registry. Each patient was matched with five comparators from the general population on birth year, sex, and Charlson Comorbidity Index. The Aalen-Johansen estimator was used to calculate the cumulative risk of DP for patients and comparators from index date (defined as 1 year after diagnosis) with competing events (transplantation or relapse, death, retirement pension, or early retirement pension). Differences in cumulative incidences were calculated using Gray’s test. RTW was calculated as proportions one, three, and five years after the index date for patients holding a job before diagnosis.
Results
A total of 154 patients with ALL and 770 matched comparators were included. The 5-year cumulative risk of DP was increased fivefold for patients with ALL compared with the general population. RTW was 41.7%, 65.7%, and 60.7% one, three, and five years after the index date, respectively.
Conclusion
The risk of DP in patients with ALL increased significantly compared with the general population. Five years after the index date, RTW was 60.7% for patients with ALL.
Acknowledgments
The authors want to thank the doctors at the hematological departments in Denmark, who have provided data for the Danish National Acute Leukemia Registry.
Disclosure
Eva Futtrup Maksten, Rasmus Rask Kragh Jørgensen, Kirsten Fonager, Ingolf Mølle, Andreas Due Ørskov, Ulrik Malthe Overgaard, and Marianne Tang Severinsen have no conflicts of interest to report in this work. Ms Mathilde Pedersen reports grants from Aalborg University, during the conduct of the study. Mrs Rie Sander Bech reports non-financial support from Pfizer, outside the submitted work. Mrs Claudia Schöllkopf reports personal fees from BMS, Incyte; virtual congress fee from Novartis, outside the submitted work. Tarec C. El-Galaly is a former employee of Roche. Gunhild Nynke Thomsen reports educational fee (podcast development) from Pfizer.