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Therapeutic strategies and treatment sequencing in patients with chronic lymphocytic leukemia: An international study of ERIC, the European Research Initiative on CLL

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CHATZIKONSTANTINOU Thomas SCARFO Lydia MINGA Eva KARAKATSOULIS Georgios CHAMOU Dimitra KOTAŠKOVÁ Jana IACOBONI Gloria DEMOSTHENOUS Christos ALBI Elisa ALCOCEBA Miguel AL-SHEMARI Salem AURRAN-SCHLEINITZ Therese BACCHIARRI Francesca CHATZILEONTIADOU Sofia COLLADO Rosa DAVIS Zadie DANIEL de Deus Santos Marcos DIMOU Maria DMITRIEVA Elena DONALDSON David GIMENA Dos Santos DRETA Barbara EFSTATHOPOULOU Maria EL-ASHWAH Shaimaa ENRICO Alicia FRYGIER Andrzej GALIMBERTI Sara GALITZIA Andrea GIMENO Eva GUARENTE Valerio GUIEZE Romain HARROP Sean HATZIMICHAEL Eleftheria HERISHANU Yair HERNANDEZ-RIVAS Jose-angel JAKSIC Ozren KALICINSKA Elzbieta LARIBI Kamel KARAKUS Volkan KATER Arnon P KHO Bonnie KISLOVA Maria KONSTANTINOU Eliana KOREN-MICHOWITZ Maya KOTSIANIDIS Ioannis KUBOVA Zuzana LABRADOR Jorge LAD Deepesh LAURENTI Luca LONGVAL Thomas LOPEZ-GARCIA Alberto MARQUET Juan MASLEJOVA Stanislava MAYOR-BASTIDA Carlota MIHALJEVIC Biljana MILOSEVIC Ivana MIRAS Fatima MOIA Riccardo MORAWSKA Marta NATH Uttam K NAVARRO-BAILON Almudena OLIVIERI Jacopo PANOVSKA-STAVRIDIS Irina PAPAIOANNOU Maria PIERIE Cheyenne PUIGGROS Anna REDA Gianluigi RIGOLIN Gian M RUCHLEMER Rosa SCHIPANI Mattia SCHIWITZA Annett SHEN Yandong SHOKRALLA Tereza SIMKOVIC Martin SMIRNOVA Svetlana SOLIMAN Dina S A STILGENBAUER Stephan TADMOR Tamar TOMIC Kristina TSE Eric VASSILAKOPOULOS Theodoros VISENTIN Andrea VITALE Candida VRACHIOLIAS George VUKOVIC Vojin WALEWSKA Renata XU Zhenshu YAGCI Munci YANEZ Lucrecia YASSIN Mohamed ZUCHNICKA Jana OSCIER David GOZZETTI Alessandro PANAGIOTIDIS Panagiotis BOSCH Francesc SPORTOLETTI Paolo ESPINET Blanca PANGALIS Gerassimos A POPOV Viola M MULLIGAN Stephen ANGELOPOULOU Maria DEMIRKAN Fatih PAPAJIK Tomas BIDERMAN Bella MURRU Roberta COSCIA Marta TAM Constantine CUNEO Antonio GAIDANO Gianluca CLAUS Rainer STAVROYIANNI Niki TRENTIN Livio ANTIC Darko SMOLEJ Lukas KALASHNIKOVA Olga B CATHERWOOD Mark SPACEK Martin POSPÍŠILOVÁ Šárka DOUBEK Michael NIKITIN Eugene CHATZIDIMITRIOU Anastasia GHIA Paolo STAMATOPOULOS Kostas

Year of publication 2024
Type Article in Periodical
Magazine / Source HemaSphere
MU Faculty or unit

Faculty of Medicine

Citation
Web https://onlinelibrary.wiley.com/doi/10.1002/hem3.70004
Doi http://dx.doi.org/10.1002/hem3.70004
Keywords chronic lymphocytic leukemia
Attached files
Description Novel small molecule inhibitors have revolutionized the treatment of chronic lymphocytic leukemia (CLL). Indeed, BTK (BTKi) and BCL2 inhibitors (BCL2i) alone or in combination with each other or other compounds have proven superior to chemoimmunotherapy (CIT) in both the frontline and the relapsed/refractory (R/R) setting.1 ERIC, the European Research Initiative on CLL, conducted this international multicenter retrospective study focused on the era of CIT, aiming to (i) reveal the treatment patterns in the “real world” and (ii) assess the outcomes of patients who received frontline treatment between 2000 and 2016. Overall, 7382 patients with CLL (7134, 96.6%) or SLL (248, 3.4%) from 76 centers in 25 countries in five continents were included. The median age at diagnosis was 64 (interquartile range [IQR]: 56–71) years and the median age at first treatment was 66 (IQR: 58–74) years. The median follow-up was 7.33 (IQR: 4.56–10.81) years from diagnosis and 5.27 (IQR: 3.04–7.99) from first treatment. The vast majority of patients (6873/7134, 93.2%) received at least one line of chemotherapy or CIT; only 197/7134 (2.7%) received exclusively novel agents. Baseline characteristics and disease-specific biomarkers are listed in Supporting Information Material. The most common first-line regimen was FCR (2609, 35.3%), mostly in young patients (median age at first treatment: 60 years, IQR: 54–66), followed by chlorambucil monotherapy (1293, 17.5%), mostly in older patients (median age at first treatment: 74 years, IQR: 65–80). BTKis as first-line treatment were used in 149/7134 (2%) patients who either participated in clinical trials and/or had TP53 aberrations; 20/7134 (0.3%) received frontline venetoclax-based regimens, all in the context of clinical trials (Figure 1). Detailed outcomes for the most common frontline regimens are provided in Supporting Information Material.
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