LONGITUDINAL TREATMENT PATTERNS AND OUTCOMES OF CHRONIC LYMPHOCYTIC LEUKEMIA IN ISRAEL (2009-2018)
Author(s): ,
Clara Weil
Affiliations:
Maccabitech Institute for Research and Innovation,Maccabi Healthcare Services,Tel Aviv,Israel;Sackler Faculty of Medicine,Tel Aviv University,Tel Aviv,Israel
,
Gabriel Chodick
Affiliations:
Maccabitech Institute for Research and Innovation,Maccabi Healthcare Services,Tel Aviv,Israel;Sackler Faculty of Medicine,Tel Aviv University,Tel Aviv,Israel
,
Varda Shalev
Affiliations:
Maccabitech Institute for Research and Innovation,Maccabi Healthcare Services,Tel Aviv,Israel;Sackler Faculty of Medicine,Tel Aviv University,Tel Aviv,Israel
,
Inna Kan
Affiliations:
Abbvie Inc.,Hod Hasharon,Israel
,
Ran Afik
Affiliations:
Abbvie Inc.,Hod Hasharon,Israel
,
Raanan Cohen
Affiliations:
Abbvie Inc.,Hod Hasharon,Israel
,
Kavita Sail
Affiliations:
Abbvie Inc.,Chicago, Illinois,United States
Yair Herishanu
Affiliations:
Department of Hematology,Tel-Aviv Sourasky Medical Center,Tel Aviv,Israel;Sackler Faculty of Medicine,Tel Aviv University,Tel Aviv,Israel
EHA Library. Afik R. Jun 15, 2019; 266783; PS1166
Ran Afik
Ran Afik
Contributions
Abstract

Abstract: PS1166

Type: Poster Presentation

Presentation during EHA24: On Saturday, June 15, 2019 from 17:30 - 19:00

Location: Poster area

Background
The treatment landscape for chronic lymphocytic leukemia (CLL) is evolving. Recent updates to the Israeli National List of Health Services include fludarabine/rituximab (FR-based regimen, 2009), bendamustine (2014), obinutuzumab, ofatumumab, ibrutinib (2015) and venetoclax (2017).

Aims

To describe treatment patterns and outcomes of CLL patients in a large unselected population.

Methods
A retrospective study was conducted using the database of Maccabi Healthcare Services, a 2.2-million-member health payer-provider in Israel. CLL was defined by cross-linking diagnosis, pharmacy and laboratory data. Newly diagnosed (1999-2017) and treated (2009-2017) patients were followed from first line (L1) through 31/3/2018 for overall survival (OS) and progression to second line (L2). 

Results

Included were 411 patients; mean (± SD) age was 63.8 (±11.5) years (63.7% male), with a median 2.9 years since diagnosis. Regimens FR-based, bendamustine/rituximab (BR-based) and obinutuzumab±chlorambucil  (G-Clb) accounted for 19.5%, 12.2% 11.4% of L1, respectively. L1 also included chlorambucil monotherapy (22.3%) and rituximab ± chemotherapy other than FR/BR (R±CT; 27.5%). Median (95% CI) OS was 7.0 (6.3-7.7) years, with 75% of FR-based patients surviving >5.7 years. Median time to L2 for FR-based, BR-based and any L1 was 4.9(3.1-6.7) years, 3.1(1.5-4.7) years and 3.1(2.6-3.6) years, respectively. L2 included 26.6% ibrutinib. Progression to L2 was significantly associated with male sex, older age, lower socioeconomic status, and L1 regimen (chlorambucil or R±CT vs. FR-based).

Conclusion
Treated CLL patients survived a median of 7 years and half progressed to L2 within 5 years. These real-world data are of high importance in the changing treatment landscape of CLL.

Session topic: 6. Chronic lymphocytic leukemia and related disorders - Clinical

Keyword(s): Chronic lymphocytic leukemia, Survival

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