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. 2019 Sep;103(3):190-199.
doi: 10.1111/ejh.13273. Epub 2019 Jul 25.

Observational evidence from patients diagnosed with chronic lymphocytic leukaemia (CLL) in Finland between 2005-2015 show improved survival over time

Vesa Lindström  1 , Katja M Hakkarainen  2 , Juha Mehtälä  3 , Riho Klement  4 , Amy Leval  5 , Tiina M Järvinen  6
Affiliations

Observational evidence from patients diagnosed with chronic lymphocytic leukaemia (CLL) in Finland between 2005-2015 show improved survival over time

Vesa Lindström et al. Eur J Haematol. 2019 Sep.

Abstract

Objectives: We aimed to describe treatment patterns of chronic lymphocytic leukaemia (CLL) patients in routine practice settings, compare overall survival and time-to-next-treatment among patients treated in different time periods (2005-2008, 2009-2013, 2014-2015), and explore associated factors.

Methods: This retrospective cohort study included adult CLL patients from the Finnish Hematology Registry.

Results: In total, 124 and 64 CLL patients received first- and second-line treatments, respectively. The use of first- and second-line treatments with bendamustine-rituximab (BR) increased, while chlorambucil-based treatments decreased over time. Patients treated in more recent years showed a trend towards longer first- and second-line survival. A trend towards inferior overall survival was detected in first- and second-line treatment with B/BR. First-line time-to-next-treatment was longer for patients treated in the later years towards 2015, while second-line time-to-next-treatment did not improve over time.

Conclusions: This study identified that improved treatment outcomes over time were likely influenced by patient characteristics and treatments, but also through other factors unexplored in this study. Hence, further research on the factors influencing patients' survival over time is needed. In particular, research on using B/BR in clinical practice is warranted.

Keywords: Finland; chemoimmunotherapy; chronic lymphocytic leukaemia; epidemiology; registry; survival.

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Conflict of interest statement

VL reports no conflict of interest. KMH, JM and RK are employed by StatFinn & EPID Research, which is a contract research organization that performs commissioned pharmacoepidemiological studies and thus its employees have been and currently are working in collaboration with several pharmaceutical companies. AL and TMJ are employees of Janssen‐Cilag.

Figures

Figure 1
Figure 1
Kaplan‐Meier survival curves for first‐line overall survival (OS) (Panel A), second‐line OS (Panel B) (OS), first‐line time‐to‐next‐treatment (TTNT) (Panel C), and second‐line TTNT (Panel D), by treatment initiation period. Log‐rank P‐values for first‐line OS (Panel A): early vs. middle 0.154, early vs. late 0.969, middle vs. late 0.917. Log‐rank P‐values for second‐line OS (Panel B): early vs. middle 0.072, early vs. late 0.646, middle vs. late 0.832. Log‐rank P‐values for first‐line TTNT (Panel C): early vs. middle 0.262, early vs. late 0.076, middle vs. late 0.097. Log‐rank P‐values for second‐line TTNT (Panel D): early vs. middle 0.629, early vs. late 0.217, middle vs. late 0.608. OS, overall survival; TTNT, time‐to‐next‐treatment
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