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Chronic lymphocytic leukaemia in the Middle East: a subgroup analysis from the CREEK study on treatment patterns and
Mohamed Abdelmoaty1, Hassan Alshehri2, Sameer Alamoudi3
1Hematology Oncology, National Cancer Institute, Cairo University, Cairo, Egypt.
Insights
Chronic lymphocytic leukemia (CLL) management in the Middle East shows underuse of genetic testing and risk-based treatments. Reliance on chemoimmunotherapy (CIT) contributes to poorer outcomes and higher healthcare costs compared to targeted therapies.
Area of Science:
- Hematology
- Oncology
- Epidemiology
Background:
- Chronic lymphocytic leukemia (CLL) is a hematologic malignancy with varying clinical characteristics and treatment approaches globally.
- The Middle East (ME) region presents a unique demographic and healthcare landscape for CLL management.
- Suboptimal treatment strategies and outcomes in the ME warrant investigation.
Purpose of the Study:
- To investigate the clinical features, treatment patterns, and outcomes of CLL patients in the Middle East.
- To compare treatment approaches and identify factors influencing outcomes in the ME region.
- To highlight disparities in care and potential areas for improvement in CLL management.
Main Methods:
- A retrospective study analyzing medical records of CLL patients treated for at least 12 months (CLL-treated) or treatment-naïve (TN).
- Data collected from 442 CLL-treated and 123 TN patients across five countries in the Middle East.
- Analysis included patient demographics, disease characteristics, genetic abnormalities, treatment modalities, and healthcare resource utilization.
Main Results:
- The study included 442 CLL-treated and 123 TN patients, with a mean age around 61-63 years; most patients were male.
- Genetic testing (e.g., del(17p), TP53 aberrations) was performed in a minority of patients (18.7-20.6%).
- Chemoimmunotherapy (CIT) was the predominant first-line treatment (76.5%), while targeted therapies (17.9%) were less common, with ibrutinib being the most used.
Conclusions:
- CLL management in the ME is marked by underutilization of risk-based treatments and genetic testing, despite the availability of targeted therapies.
- The continued reliance on CIT is associated with unfavorable safety profiles and increased healthcare resource utilization compared to targeted therapies.
- Improving access to and utilization of genetic testing and targeted therapies could enhance CLL outcomes in the Middle East.
Background:
This subgroup analysis investigates the clinical characteristics, treatment patterns, and outcomes of chronic lymphocytic leukemia (CLL) in the Middle East (ME).
Research Design And Methods:
Retrospective study retrieved medical records of CLL patients treated for ≥12 months (CLL-treated) or treatment-naïve (TN). Results included data from 442 CLL-treated and 123 TN patients across five ME countries.
Results:
CLL-treated group mean age: 61.1 ± 11.28 years; TN cohort: 63.5 ± 13.53 years. Most patients in both groups were male. CLL-IPI scores were mostly unavailable in both cohorts. Cytogenetic abnormalities were tested in 20.6% of CLL-treated and 18.7% of TN cohorts, with del(17p) being the most common abnormality (12.4% and 11.4%, respectively). TP53 aberrations were found in 9.0% of CLL-treated and 9.8% of TN cohorts. Regarding first-line treatment, 76.5% received CIT, while 17.9% received targeted therapies, with ibrutinib (75.9%) being the most common. CIT use led to significant resource utilization, including outpatient visits, length of stay, and blood transfusions.
Conclusion:
CLL management in the ME is characterized by suboptimal utilization of risk-based treatment and genetic testing despite access to targeted therapy. Poor CLL outcomes stem from reliance on CIT, associated with an unfavorable safety profile and healthcare resource use compared to targeted therapies in the region.
Clinical Trial Registration:
www.clinicaltrials.gov identifier is NCT04964908.
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