Lower access to risk stratification tests and drugs, and worse survival of chronic lymphocytic leukaemia patients treated in public as compared to private hospitals in Brazil: A retrospective analysis of the Brazilian registry of chronic lymphocytic leukaemia

Pfister, Verena; Marques, Fernanda de Morais; Parra, Flavia; Yamamoto, Masahiro; Gonçalves, Morgana Scaramussa; Perobelli, Leila Martins; Buccheri, Valéria; Bandeira, Raphael; Fortier, Sérgio Costa; Azevedo, Alita; Santucci, Rodrigo; Bellesso, Marcelo; Fogliatto, Laura; Ribeiro, Gustavo Meirelles; Lopes, Germison Silva; Ikoma, Maura Rosane Valério; Figueiredo, Vera P.; Lorand-Metze, Irene; Chiattone, Carlos S.; Arrais‐Rodrigues, Celso

doi:10.1002/jha2.444

Cited by 1 publication

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“…It is possible that survival outcomes would have been improved by second- or later-line ibrutinib or access to clinical trials. Additionally, ethnic differences may have partly been involved in response to chlorambucil or CITs [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Treatment pattern of chronic lymphocytic leukemia/small lymphocytic lymphoma in Korea: a multicenter retrospective study (KCSG LY20-06)

Kim¹,

Kim²,

Kang³

et al. 2023

Korean J Intern Med

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Background/Aims: Little attention is paid to chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) in Korea due to the rarity of the disease. With its rising incidence, we aimed to evaluate recent changes in treatment patterns and survival outcomes of patients with CLL/SLL.Methods: A total of 141 patients diagnosed with CLL/SLL between January 2010 and March 2020 who received systemic therapy were analyzed in this multicenter retrospective study.Results: The median patient age was 66 years at diagnosis, and 68.1% were male. The median interval from diagnosis to initial treatment was 0.9 months (range: 0–77.6 months), and the most common treatment indication was progressive marrow failure (50.4%). Regarding first-line therapy, 46.8% received fludarabine, cyclophosphamide, plus rituximab (FCR), followed by chlorambucil (19.9%), and obinutuzumab plus chlorambucil (GC) (12.1%). The median progression-free survival (PFS) was 49.3 months (95% confidence interval [CI], 32.7–61.4), and median overall survival was not reached (95% CI, 98.4 mo– not reached). Multivariable analysis revealed younger age (≤ 65 yr) (hazard ratio [HR], 0.46; p < 0.001) and first-line therapy with FCR (HR, 0.64; p = 0.019) were independently associated with improved PFS. TP53 aberrations were observed in 7.0% (4/57) of evaluable patients. Following reimbursement, GC became the most common therapy among patients over 65 years and second in the overall population after 2017.Conclusions: Age and reimbursement mainly influenced treatment strategies. Greater effort to apply risk stratifications into practice and clinical trials for novel agents could help improve treatment outcomes in Korean patients.

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Section: Discussionmentioning

confidence: 99%