Survival Outcomes in Chronic Lymphocytic Leukemia During the Novel Agent Era: A Population-Based Analysis

Chemoimmunotherapy (CIT) had long been used to treat chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) until 2014 when the first novel agent, ibrutinib, was approved in the United States. Numerous novel therapies have since become available. Nevertheless, as novel therapies have largely replaced CIT in CLL/SLL, its impact on survival has yet to be examined on the population level. In this study, we used the SEER (Surveillance, Epidemiology, and End Results) database to compare survival in patients with CLL/SLL before and after the approval of the first novel therapy. We included 9913 patients who started treatment within 2 years of CLL/SLL diagnosis. In the multivariable analyses, the overall survival improved significantly (hazard ratio [HR]: 0.86, 95% confidence interval: 0.81, 0.92), and death from CLL/SLL and other cancer (subdistribution-HR: 0.69 and 0.77) also decreased significantly. Nevertheless, CLL/SLL remains the main cause of death during the novel agent era.