Treatment pattern of chronic lymphocytic leukemia/small lymphocytic lymphoma in Korea : a multicenter retrospective study (KCSG LY20-06)open access
- Authors
- Kim, Jung Sun; Kim, Tae Min; Kang, Myoung Joo; Koh, Sung Ae; Park, Hyunkyung; Nam, Seung-Hyun; Han, Jae Joon; Lee, Gyeong-Won; Yuh, Young Jin; Lee, Hee Jeong; Choi, Jung Hye
- Issue Date
- Sep-2023
- Publisher
- KOREAN ASSOC INTERNAL MEDICINE
- Keywords
- Leukemia; lymphocytic; chronic; B-cell; Insurance; health; reimbursement; Treatment outcome
- Citation
- KOREAN JOURNAL OF INTERNAL MEDICINE, v.38, no.5, pp.747 - 757
- Indexed
- SCIE
SCOPUS
KCI
- Journal Title
- KOREAN JOURNAL OF INTERNAL MEDICINE
- Volume
- 38
- Number
- 5
- Start Page
- 747
- End Page
- 757
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/192996
- DOI
- 10.3904/kjim.2022.408
- ISSN
- 1226-3303
- Abstract
- 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 ma row failure (50.4%). Regarding first-line therapy, 46.8% received fludarabine, cyclophosphamide, plus rituximab (FCR), fo lowed 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.<italic> TP53</italic> 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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