Evolution in the frontline treatment of patients with chronic lymphocytic leukemia: experience from one European center

Abstract

Treatment of chronic lymphocytic leukemia (CLL) has dramatically evolved over the last decades thanks to the introduction of targeted therapies. We aimed to describe retrospectively the evolution in the frontline prescription in the CLL patients from our institution. As a secondary objective, the impact of frontline therapy on the time-to-next-treatment (TTNT) and overall survival (OS). After a median of 6.4 years (0.1–36.4) of follow-up from diagnosis, 323 of 780 CLL patients (41.4%) required therapy. Alkylating agents in monotherapy (chlorambucil) were the most used until 2012, and from then, chemoimmunotherapy. Since 2018, targeted therapies were the most common therapeutic strategy (74.1%). Patients who received targeted therapies had significantly longer TTNT compared to other regimens. In the multivariable analyses, mutated IGHV genes targeted therapies and chemoimmunotherapy regimens were related to longer TTNT, and sex female, age younger than 65, and mutated IGHV genes were associated with better OS.

Keywords:

• CLL
• targeted therapies
• prognosis
• frontline

Acknowledgements

We appreciate the support of the hospital staff, the patients, and their families.

Authorship contributions

M.A., N.A., P.J. and A.M. performed research. M.A. and C.M. designed research. M.A. C.M, and N.A. analyzed data. M.A. and C.M. wrote the paper. C.M., J.N., S.R., S.S., S.N., I.G., R.M. and J.S supervised research and wrote the paper. All authors reviewed the final manuscript.

Disclosure statement

Miguel Arguello-Tomas has received honoraria from Janssen, Astrazeneca and Abbvie.

Nil Albiol has received honoraria from Janssen, Astrazeneca and Abbvie.

Carol Moreno has received honoraria from Abbvie, AstraZeneca, Janssen, Lilly, Ascentage, Beigene, BMS, Grifols and research suport from Janssen, Abbvie and AstraZeneca.

Alba Mora has received honoraria from Abbvie and has received research grants from Abbvie and Janssen.

Additional information

Funding

This study was supported in part by the Spanish Ministry of Science through grants from Red Temática de Investigación Cooperativa en Cáncer (RD12/0036/0071 to J.S) Instituto de Salud Carlos III (FIS PI19/00753 to C.M) and a research grant from Deutsche José Carreras Leukämie Stiftung e.V.