Características clínicas, vía de tratamiento y utilización de recursos para pacientes con leucemia linfocítica...

This study describes the clinical characteristics, treatment pathways, and resource utilisation of patients with chronic lymphocytic leukaemia (CLL) across multiple regions.

This retrospective, observational, registry-based study included patients diagnosed with CLL who started treatment for at least 12 months before data collection (November 2021 to March 2023). Patients were recruited from multiple centres across Asia, Australia, Latin America, and the Middle East and North Africa. A pilot cohort was included to describe the clinical characteristics of treatment-naïve CLL patients.

The study included 886 patients in the CLL-treated and 123 in the treatment-naïve cohorts. The mean age was nearly 63 years in both cohorts, with a majority being male. There was low utilisation of risk scores (74-76.9 % of the patients had no available scores). The Rai staging showed that the majority of the treatment-naïve cohort was in stage 0 (60.6 %), while the CLL-treated cohort had a more even distribution across all stages. The Cumulative Illness Rating Scale score showed that 60.9 % of the CLL-treated cohort had a score of ≥ 6, compared to 58.5 % in the treatment-naïve cohort. The Fluorescence in situ hybridisation (FISH)-based prognosis was available for 41.2 % of the CLL-treated cohort and 56.9 % of the treatment-naïve cohort. The cytogenetic testing was available for only 18.7 % of the CLL-treated cohort. The chemoimmunotherapy (CIT) regimens were the most commonly prescribed regimen, with a median first-line progression-free survival (PFS) of 26.1 months (95 % CI: 13.8, 42.8). Targeted therapies in the first-line setting were used by 20.2 % of patients. For first-line therapy, the objective response rate for CIT was 53.2 % (95 % CI: 49.5 %, 57 %), compared to 56.4 % (95 % CI: 49.2 %, 63.7 %) for targeted therapies. Patients receiving CIT had significantly higher rates of adverse events, inpatient hospitalisations, longer hospital stays, and a greater need for blood transfusions.

The present global study demonstrates the regional variations in the presentation and outcomes of CLL. A considerable number of patients with CLL present with advanced disease staging at diagnosis; still, the utilisation of genetic testing is low despite the plethora of approved targeted therapy.