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Original Articles

Real-world patterns and sequences of targeted therapy use in chronic lymphocytic leukemia and small lymphocytic lymphoma in the United States: a longitudinal study

, , , , , , , , , , & show all
Pages 932-942 | Received 29 Jan 2024, Accepted 12 Mar 2024, Published online: 02 May 2024

Figures & data

Figure 1. Patient selection flowchart.

1L: first line; BCL2i: B-cell lymphoma-2 inhibitor; BTKi: Bruton’s tyrosine kinase inhibitor; CLL: chronic lymphocytic leukemia; CPT: Current Procedural Terminology; HCPCS: Healthcare Common Procedure Coding System; ICD-9/10-CM: International Classification of Diseases, 9/10th Revision, Clinical Modification; ICD-9/10-PCS: International Classification of Diseases, 9/10th Revision, Procedure Coding System; NDC: National Drug Code; SLL: small lymphocytic lymphoma.

1Diagnosis of CLL was identified using ICD-9-CM code 204.1 and ICD-10-CM code C91.1; diagnosis of SLL was identified using ICD-10-CM code C83.0. Patients with one CLL diagnosis and one SLL diagnosis on different dates were included.

2CLL- or SLL-related anticancer therapies included BTKi, BCL2i, CD20, chemotherapy, chemoimmunotherapy, radiation therapy, chimeric antigen receptor T-cell therapy, and hematopoietic stem cell transplantation and were identified using NDC, HCPCS, CPT, and ICD-9/10-PCS codes.

3BTKi or BCL2i-related malignancies included acute myeloid leukemia, chronic graft versus host disease, CLL/SLL, mantle cell lymphoma, marginal zone lymphoma, and Waldenstrom’s macroglobulinemia and were identified using ICD-9/10-CM codes.

Figure 1. Patient selection flowchart.1L: first line; BCL2i: B-cell lymphoma-2 inhibitor; BTKi: Bruton’s tyrosine kinase inhibitor; CLL: chronic lymphocytic leukemia; CPT: Current Procedural Terminology; HCPCS: Healthcare Common Procedure Coding System; ICD-9/10-CM: International Classification of Diseases, 9/10th Revision, Clinical Modification; ICD-9/10-PCS: International Classification of Diseases, 9/10th Revision, Procedure Coding System; NDC: National Drug Code; SLL: small lymphocytic lymphoma.1Diagnosis of CLL was identified using ICD-9-CM code 204.1 and ICD-10-CM code C91.1; diagnosis of SLL was identified using ICD-10-CM code C83.0. Patients with one CLL diagnosis and one SLL diagnosis on different dates were included.2CLL- or SLL-related anticancer therapies included BTKi, BCL2i, CD20, chemotherapy, chemoimmunotherapy, radiation therapy, chimeric antigen receptor T-cell therapy, and hematopoietic stem cell transplantation and were identified using NDC, HCPCS, CPT, and ICD-9/10-PCS codes.3BTKi or BCL2i-related malignancies included acute myeloid leukemia, chronic graft versus host disease, CLL/SLL, mantle cell lymphoma, marginal zone lymphoma, and Waldenstrom’s macroglobulinemia and were identified using ICD-9/10-CM codes.

Table 1. Patient demographic and clinical characteristics.

Table 2. 1 L To 3 L treatments observed in the overall data cohort.

Table 3. Sequential targeted therapy by class and by BTKi agent among patients with ≥2 LOTs.

Supplemental material

Supplemental Material

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Data availability statement

The data that support the findings of this study are available from Optum, but restrictions apply to the availability of these data, which were used pursuant to a data use agreement. Data are available from the authors with the permission of Optum.