Prognostic impacts of marital status and other socioeconomic factors in patients with chronic lymphocytic leukemia: an analysis of SEER database.

BACKGROUND

Marital status has been demonstrated to impact the outcomes of several malignancies. The prognostic role of marital status in chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) has not been determined.

METHODS

We identified 67,238 patients with CLL/SLL from the Surveillance, Epidemiology, and End Results (SEER) database. The patients were randomly divided into the training and validation cohorts. The univariate and multivariate Cox regression analyses were performed to screen the predictors for overall survival (OS) and disease-specific survival (DSS). The nomograms were developed and validated by the C-index, calibration curve, receiver-operating characteristic (ROC) curve, and decision curve analysis.

RESULTS

Marital status was an independent predictor of OS and DSS, with married patients having the best survival compared to single, divorced, and widowed patients. The nomograms for OS and DSS containing marital status were constructed, respectively. The C-index and ROC curve indicated that the models have favorable discrimination. The calibration curve showed good predictive accuracy. Decision curve analysis demonstrated considerable clinical net benefits. According to the points of the nomograms, patients were divided into three risk groups with distinct outcomes.

CONCLUSION

Married marital status correlated with better survival in patients with CLL/SLL. The integration of marital status into validated nomograms provides a clinically accessible tool for improved risk stratification. Identifying widowed patients as a high-risk subgroup enables targeted interventions and optimized surveillance strategies in CLL/SLL management.