Supplementary Material for: Intake of Proton Pump Inhibitors is Associated with a Shorter Time To First Treatment in early-stage Chronic Lymphocytic Leukemia.

Proton pump inhibitors (PPIs) are one of the most widely used drugs worldwide(1). The use of PPI has become a common practice, and are overprescribed for all patients with cancer including patients with hematological malignancies.
In the current study, we aimed to explore retrospectively the effect of PPI, on time to first treatment (TTFT) in a large cohort of patients with Chronic lymphocytic leukemia who were under watch and wait approach.
Our cohort included 3,474 patients with CLL who are treatment-naïve, and the median follow-up was 1745 days (602-3700). 1061 patients (30.5%) received a PPI agent, for a minimum of 3 months during the watch-and-wait period.
The intake of PPI was found to be associated with a shorter TTFT: among PPI users, the ten years treatment free ratio is 79.2%, while among non PPI users it is 90.6%.
In conclusion, routine use of PPI in CLL patients may negative impact their clinical course. Biology of this primary observation require further investigation.

质子泵抑制剂（Proton pump inhibitors, PPIs）是全球范围内应用最为广泛的药物之一[1]。其临床应用已极为普遍，且在包括血液系统恶性肿瘤患者在内的所有癌症患者中存在过度处方现象。
本研究旨在回顾性分析质子泵抑制剂对采用观察等待策略的慢性淋巴细胞白血病（Chronic lymphocytic leukemia, CLL）患者首次治疗时间间隔（time to first treatment, TTFT）的影响。
本研究队列共纳入3474例初治慢性淋巴细胞白血病患者，中位随访时间为1745天（范围602~3700天）。其中1061例（30.5%）患者在观察等待期间至少连续3个月使用了质子泵抑制剂。
研究发现，质子泵抑制剂的使用与更短的首次治疗时间间隔相关：质子泵抑制剂使用者的10年无治疗比例为79.2%，而非使用者则为90.6%。
综上，慢性淋巴细胞白血病患者常规使用质子泵抑制剂可能对其临床进程产生负面影响。该初步观察结果的生物学机制尚需进一步研究阐明。