Real-world treatment patterns in first line and relapsed Chronic Lymphocytic Leukemia (CLL)

Results: Of 2,013 CLL patients meeting inclusion criteria, median age at diagnosis was 72 years, 78% were ≥65 years of age, 61% were male, mean age-adjusted Charlson comorbidity index was 5, and 27% had a comorbidity index >5. In first-line treatment, rituximab-based regimens were used in 73.1% of patients, and 16.8% received rituximab maintenance. Regimens in order of frequency included fludarabine-based (28.6%), rituximab monotherapy (27.2%), bendamustine-based (17.8%), cyclophosphamide-based (10.9%), chlorambucil-based (10.2%), alemtuzumab-based (1.4%), followed by other therapies (3.9%). In the relapsed setting, 65.6% received rituximab-based regimens and 11.9% received rituximab maintenance. Regimens in order of frequency were bendamustine-based (26.1%), fludarabine-based (19.8%), rituximab monotherapy (19.6%), cyclophosphamide-based (14.9%), alemtuzumab-based (4.0%), followed by other regimens (10.5%). Only 12 patients (<1%) received stem cell transplantation. Patients <65 received fludarabine regimens more frequently and stayed on longer than patients ≥65. Comorbidity index may play a role in treatment choice; the <65 age group had a mean comorbidity index of 3.5 compared to 5.8 for the ≥65 age group. Mean time to next treatment in first-line was 273 days compared to 198 days in the relapsed setting.