Significant clinical and economic burden was associated with chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) among US veterans, according to real-world data presented at the 63rd ASH Annual Meeting & Exposition.

The Veterans Health Administration identified 13,664 adults newly diagnosed with CLL or SLL between October 2014 and September 2019, of which 79% were in watch-and-wait.

The final study consisted of 2861 patients who received at least 1 line of CLL/SLL therapy and of these patients majority were older (aged >70 years) white (83%) men (98%). According to authors of the study, at baseline approximately 39% of veterans had concurrent use of proton pump inhibitors and 315 days was the average time to treatment initiation from diagnosis to first-line therapy.

Results of the study showed that a total of 26.9% of patients further received second-line therapy over a mean duration of 318 days of treatment and 7% of patients received third-line therapy with a mean duration of 228 days of treatment.

“Ibrutinib was the most common treatment regimen across all lines of therapy (first-line: 39%; second-line: 55%; third-line: 43%) with discontinuation rates at 59.6%, 60.1%, and 55.2% in first-, second-, third-line therapy respectively,” stated authors of the study. “The CLL/SLL-related hospitalization rate was 39% with an average length of stay (LOS) of 7 days. Total per-patient-per-month (PPPM) all-cause and CLL/SLL-related costs were $26,709 and $17,233, respectively; these costs were increased by line of therapy.”

Treatment discontinuation, treatment switching, and controlling for patient clinical and demographic covariates were statistically significant predictors of LOS of hospitalizations, higher inpatient admissions, and costs.

“Furthermore, the suboptimal adherence, as reported by high treatment discontinuation rates and its impact on increasing costs, and health care resource use, highlights the real-world unmet needs of CLL/SLL management in the veteran population” concluded authors of the study.

To further understand the long-term outcomes of each treatment regimen, researchers note future studies are needed.

Reference:
Yang, K, Liu S, Tang B, Chanan-Khan A. Real-world treatment patterns, adherence and health care resource utilization for chronic lymphocytic leukemia/small lymphocytic leukemia among veterans in the United States. Poster presented at: 63rd ASH Annual Meeting & Exposition; December 11-14, 2021; Atlanta, GA.