Treatment pattern of chronic lymphocytic leukemia/small lymphocytic lymphoma in Korea: a multicenter retrospective study (KCSG LY20-06)
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 tota...
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| Format: | Article |
| Language: | English |
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The Korean Association of Internal Medicine
2023-09-01
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| Series: | The Korean Journal of Internal Medicine |
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| Online Access: | http://kjim.org/upload/kjim-2022-408.pdf |
| _version_ | 1827822216442544128 |
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| author | Jung Sun Kim Tae Min Kim Myoung Joo Kang Sung Ae Koh Hyunkyung Park Seung-Hyun Nam Jae Joon Han Gyeong-Won Lee Young Jin Yuh Hee Jeong Lee Jung Hye Choi |
| author_facet | Jung Sun Kim Tae Min Kim Myoung Joo Kang Sung Ae Koh Hyunkyung Park Seung-Hyun Nam Jae Joon Han Gyeong-Won Lee Young Jin Yuh Hee Jeong Lee Jung Hye Choi |
| author_sort | Jung Sun Kim |
| collection | DOAJ |
| description | 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 marrow failure (50.4%). Regarding first-line therapy, 46.8% received fludarabine, cyclophosphamide, plus rituximab (FCR), followed 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. TP53 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. |
| first_indexed | 2024-03-12T01:53:57Z |
| format | Article |
| id | doaj.art-1e6ad20e90a24fc19658f4ed258c3970 |
| institution | Directory Open Access Journal |
| issn | 1226-3303 2005-6648 |
| language | English |
| last_indexed | 2024-03-12T01:53:57Z |
| publishDate | 2023-09-01 |
| publisher | The Korean Association of Internal Medicine |
| record_format | Article |
| series | The Korean Journal of Internal Medicine |
| spelling | doaj.art-1e6ad20e90a24fc19658f4ed258c39702023-09-08T06:41:56ZengThe Korean Association of Internal MedicineThe Korean Journal of Internal Medicine1226-33032005-66482023-09-0138574775710.3904/kjim.2022.408170811Treatment pattern of chronic lymphocytic leukemia/small lymphocytic lymphoma in Korea: a multicenter retrospective study (KCSG LY20-06)Jung Sun Kim0Tae Min Kim1Myoung Joo Kang2Sung Ae Koh3Hyunkyung Park4Seung-Hyun Nam5Jae Joon Han6Gyeong-Won Lee7Young Jin Yuh8Hee Jeong Lee9Jung Hye Choi10 Department of Internal Medicine, Chungnam National University Sejong Hospital, Sejong, Korea Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea Department of Internal Medicine, Inje University Haeundae Paik Hospital, Busan, Korea Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu, Korea Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea Department of Hematology and Medical Oncology, College of Medicine, Kyung Hee University, Seoul, Korea Division of Hematology and Oncology, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea Department of Internal Medicine, Inje University Sanggye Paik Hospital, Seoul, Korea Division of Hematology and Oncology, Department of Internal Medicine, Chosun University Hospital, Gwangju, Korea Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, KoreaBackground/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 marrow failure (50.4%). Regarding first-line therapy, 46.8% received fludarabine, cyclophosphamide, plus rituximab (FCR), followed 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. TP53 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.http://kjim.org/upload/kjim-2022-408.pdfleukemialymphocyticchronicb-cellinsurancehealthreimbursementtreatment outcome |
| spellingShingle | Jung Sun Kim Tae Min Kim Myoung Joo Kang Sung Ae Koh Hyunkyung Park Seung-Hyun Nam Jae Joon Han Gyeong-Won Lee Young Jin Yuh Hee Jeong Lee Jung Hye Choi Treatment pattern of chronic lymphocytic leukemia/small lymphocytic lymphoma in Korea: a multicenter retrospective study (KCSG LY20-06) The Korean Journal of Internal Medicine leukemia lymphocytic chronic b-cell insurance health reimbursement treatment outcome |
| title | Treatment pattern of chronic lymphocytic leukemia/small lymphocytic lymphoma in Korea: a multicenter retrospective study (KCSG LY20-06) |
| title_full | Treatment pattern of chronic lymphocytic leukemia/small lymphocytic lymphoma in Korea: a multicenter retrospective study (KCSG LY20-06) |
| title_fullStr | Treatment pattern of chronic lymphocytic leukemia/small lymphocytic lymphoma in Korea: a multicenter retrospective study (KCSG LY20-06) |
| title_full_unstemmed | Treatment pattern of chronic lymphocytic leukemia/small lymphocytic lymphoma in Korea: a multicenter retrospective study (KCSG LY20-06) |
| title_short | Treatment pattern of chronic lymphocytic leukemia/small lymphocytic lymphoma in Korea: a multicenter retrospective study (KCSG LY20-06) |
| title_sort | treatment pattern of chronic lymphocytic leukemia small lymphocytic lymphoma in korea a multicenter retrospective study kcsg ly20 06 |
| topic | leukemia lymphocytic chronic b-cell insurance health reimbursement treatment outcome |
| url | http://kjim.org/upload/kjim-2022-408.pdf |
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