Epidemiology, longitudinal treatment patterns and outcomes of chronic lymphocytic leukemia in Israel.

Clara Weil, Gabriel Chodick, Varda Shalev, Inna Kan, Ran Afik, Raanan Cohen, Kavita Sail, Yair Herishanu

Leukemia & lymphoma 2021 May

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This study aims to describe chronic lymphocytic leukemia (CLL) epidemiology, treatment patterns and outcomes in a 2.3-million-member healthcare provider database (Maccabi Healthcare Services, Israel). Newly-diagnosed CLL patients (1999-2017) were followed through 31/3/2018. A total of 1857 newly-diagnosed CLL patients were included. Annual incidence was 5.82 per 100,000 population. Median overall survival (OS) was 12.7 (95%CI: 11.8-13.5) years since diagnosis. Approximately 1/3 initiated treatment within 5 y. A statistical trend (p = 0.066) for improved OS over time was observed among younger patients (age <70 y) treated in 2009-2017 vs. 1999-2008). Among patients treated since 2009 (n = 411; median age = 68y), fludarabine-cyclophosphamide-rituximab (FCR), bendamustine-rituximab and obinutuzumab ± chlorambucil accounted for 19.5%, 12.2% and 11.4% of first line, respectively. Median (95%CI) time to next treatment and OS were 3.1(2.6-3.6) and 7.0(6.3-7.7) years, respectively. CLL incidence in Israel is comparable to developed countries. Real-world data suggest a trend of improved survival over the last decade among patients treated before age 70.

Citation

Clara Weil, Gabriel Chodick, Varda Shalev, Inna Kan, Ran Afik, Raanan Cohen, Kavita Sail, Yair Herishanu. Epidemiology, longitudinal treatment patterns and outcomes of chronic lymphocytic leukemia in Israel. Leukemia & lymphoma. 2021 May;62(5):1136-1145