Analysis of racial variations in disease characteristics, treatment patterns, and outcomes of patients with chronic lymphocytic leukemia

Abstract

The impact of race on outcomes of patients with chronic lymphocytic leukemia (CLL), the most common leukemia in the west, is not well studied. We aimed to understand racial variations in clinical and disease characteristics, treatment patterns, and outcomes in patients with CLL. We utilized the Mayo Clinic CLL database to perform an analysis of these characteristics and natural history of non-white (NW) compared to white (W) CLL patients. Differences by race in median overall survival (OS) and time-to-first-treatment (TTFT) were investigated. Of the 4215 CLL patients, 4114 (97.6%) were W and 101 (2.4%) were NW. NW patients were younger (median age at diagnosis 59.4 vs. 63.4; P 5 0.003) and more likely to have an elevated LDH (28.0% vs. 16.2%; P 5 0.02). No differences in prognostic parameters were noted. No major differences were observed in treatment selection. OS and TTFT were similar between both groups. In the largest analysis of NW-CLL patients in North America, and contrary to historical retrospective reports, W and NW patients appear to have comparable outcomes when treated similarly. These findings suggest previously noted outcome differences may be due to disparities in access to care and management rather than differences in disease biology.

IGHV mutational status and outcome for patients with chronic lymphocytic leukemia upon treatment: a Danish nationwide population-based study

“…Chronic lymphocytic leukemia (CLL) is the most common type of leukemia in the Western world and half of the patients with this condition require treatment within 5 years of diagnosis. 1 According to Danish national CLL guidelines, 2,3 standard first-line treatment includes fludarabine, cyclophosphamide plus rituximab (FCR) for younger, fit patients, 4,5 and bendamustine plus rituximab (BR) for patients above 65 years old. 6,7 Furthermore, chlorambucil, either as monotherapy or com-bined with anti-CD20 antibodies (CD20-chlorambucil), is recommended for unfit patients with significant comorbidity.…”

Cause of death in patients with newly diagnosed chronic lymphocytic leukemia (CLL) stratified by the CLL-International Prognostic Index

“…This study was approved by the Mayo Clinic Institutional Review Board. Patients diagnosed with CLL between January 1, 2000 and December 26, 2019 were identified from the Mayo Clinic CLL Database, which includes consecutive CLL patients who were evaluated within one year of diagnosis in the Division of Hematology at Mayo Clinic, Rochester, MN [7]. All patients provided an informed consent form.…”

Variation in the use of up‐front chemotherapy for indolent B‐cell lymphomas and chronic lymphocytic leukemia

“…Prior studies suggested that practice setting is associated with survival disparities in lymphomas . Furthermore, some analyses from academic systems do not reproduce treatment disparities reported in population‐based studies . Further research should clarify to what extent practice‐related factors determine initial management of indolent lymphomas, particularly considering impending changes in the therapeutic landscape.…”