Assessment of second primary malignancies among treated and untreated patients with chronic lymphocytic leukemia using real-world data from the USA
Aim: Improved management of chronic lymphocytic leukemia (CLL) has resulted in a growing population of CLL survivors; these patients have a higher risk of developing second primary malignancies (SPMs) versus the general population. This retrospective cohort study aims to assess the timing, frequen...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Becaris Publishing Limited
2024-01-01
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| Series: | Journal of Comparative Effectiveness Research |
| Subjects: |
| _version_ | 1827357680341090304 |
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| author | Sikander Ailawadhi Arliene Ravelo Carmen D Ng Bonny Shah Neil Lamarre Rongrong Wang Katherine Eakle Juliana ML Biondo |
| author_facet | Sikander Ailawadhi Arliene Ravelo Carmen D Ng Bonny Shah Neil Lamarre Rongrong Wang Katherine Eakle Juliana ML Biondo |
| author_sort | Sikander Ailawadhi |
| collection | DOAJ |
| description | Aim: Improved management of chronic lymphocytic leukemia (CLL) has resulted in a growing population
of CLL survivors; these patients have a higher risk of developing second primary malignancies (SPMs) versus
the general population. This retrospective cohort study aims to assess the timing, frequency, incidence and
types of SPMs in treated and untreated patients with CLL in the USA, using the Surveillance, Epidemiology,
and End Results (SEER) Medicare database, which links a nationally representative cancer registry with
Medicare claims data. Patients & methods: Patients aged ≥66 years with newly diagnosed CLL between
1 January 2010 and 31 December 2016, who were enrolled in Parts A and B of Medicare for ≥12 months
pre-diagnosis of CLL were selected from the database. Patients were assessed for ≥36 months until the end
of continuous enrollment in Medicare Parts A, B and D, a switch to a health maintenance organization,
death, or end of the study period (December 2019). Results: Of 3053 patients included in the analyses,
620 (20.3%) were treated and 2433 (79.7%) were untreated within 36 months of diagnosis. Overall,
638 (20.9%) patients developed a SPM, 26.8% of patients in the treated cohort and 19.4% of patients
in the untreated cohort. The most common SPMs for both cohorts were squamous cell carcinoma and
acute myeloid leukemia. Among the 166 treated patients who developed a SPM, a greater proportion
developed their first SPM after treatment initiation versus those who developed their first SPM prior
to treatment initiation (p < 0.001). A significantly lower percentage of patients who received targeted
therapy developed a SPM (p < 0.05) versus patients treated with anti-CD20 + chemotherapy. Conclusion:
Findings indicate that treatment type and timing can affect SPM development in patients with CLL.
Combined with previous findings, this can help inform best practices in monitoring for SPM in patients
with CLL. |
| first_indexed | 2024-03-08T05:37:25Z |
| format | Article |
| id | doaj.art-faadf5cffea44b4aa41ecc512af99f90 |
| institution | Directory Open Access Journal |
| issn | 2042-6313 |
| language | English |
| last_indexed | 2024-03-08T05:37:25Z |
| publishDate | 2024-01-01 |
| publisher | Becaris Publishing Limited |
| record_format | Article |
| series | Journal of Comparative Effectiveness Research |
| spelling | doaj.art-faadf5cffea44b4aa41ecc512af99f902024-02-05T15:46:16ZengBecaris Publishing LimitedJournal of Comparative Effectiveness Research2042-63132024-01-0113210.57264/cer-2023-0119Assessment of second primary malignancies among treated and untreated patients with chronic lymphocytic leukemia using real-world data from the USASikander Ailawadhi0https://orcid.org/0000-0002-8377-8111Arliene Ravelo1Carmen D Ng2Bonny Shah3Neil Lamarre4Rongrong Wang5Katherine Eakle6Juliana ML Biondo7Mayo Clinic, Jacksonville, FL 32224, USAGenentech, South San Francisco, CA 94080, USAGenentech, South San Francisco, CA 94080, USAGenesis Research, Hoboken, NJ 07030, USAGenesis Research, Hoboken, NJ 07030, USAGenentech, South San Francisco, CA 94080, USAGenentech, South San Francisco, CA 94080, USAGenentech, South San Francisco, CA 94080, USAAim: Improved management of chronic lymphocytic leukemia (CLL) has resulted in a growing population of CLL survivors; these patients have a higher risk of developing second primary malignancies (SPMs) versus the general population. This retrospective cohort study aims to assess the timing, frequency, incidence and types of SPMs in treated and untreated patients with CLL in the USA, using the Surveillance, Epidemiology, and End Results (SEER) Medicare database, which links a nationally representative cancer registry with Medicare claims data. Patients & methods: Patients aged ≥66 years with newly diagnosed CLL between 1 January 2010 and 31 December 2016, who were enrolled in Parts A and B of Medicare for ≥12 months pre-diagnosis of CLL were selected from the database. Patients were assessed for ≥36 months until the end of continuous enrollment in Medicare Parts A, B and D, a switch to a health maintenance organization, death, or end of the study period (December 2019). Results: Of 3053 patients included in the analyses, 620 (20.3%) were treated and 2433 (79.7%) were untreated within 36 months of diagnosis. Overall, 638 (20.9%) patients developed a SPM, 26.8% of patients in the treated cohort and 19.4% of patients in the untreated cohort. The most common SPMs for both cohorts were squamous cell carcinoma and acute myeloid leukemia. Among the 166 treated patients who developed a SPM, a greater proportion developed their first SPM after treatment initiation versus those who developed their first SPM prior to treatment initiation (p < 0.001). A significantly lower percentage of patients who received targeted therapy developed a SPM (p < 0.05) versus patients treated with anti-CD20 + chemotherapy. Conclusion: Findings indicate that treatment type and timing can affect SPM development in patients with CLL. Combined with previous findings, this can help inform best practices in monitoring for SPM in patients with CLL.chronic lymphocytic leukemiamanagementreal-worldsecond primary malignanciestreatment |
| spellingShingle | Sikander Ailawadhi Arliene Ravelo Carmen D Ng Bonny Shah Neil Lamarre Rongrong Wang Katherine Eakle Juliana ML Biondo Assessment of second primary malignancies among treated and untreated patients with chronic lymphocytic leukemia using real-world data from the USA Journal of Comparative Effectiveness Research chronic lymphocytic leukemia management real-world second primary malignancies treatment |
| title | Assessment of second primary malignancies among treated and untreated patients with chronic lymphocytic leukemia using real-world data from the USA |
| title_full | Assessment of second primary malignancies among treated and untreated patients with chronic lymphocytic leukemia using real-world data from the USA |
| title_fullStr | Assessment of second primary malignancies among treated and untreated patients with chronic lymphocytic leukemia using real-world data from the USA |
| title_full_unstemmed | Assessment of second primary malignancies among treated and untreated patients with chronic lymphocytic leukemia using real-world data from the USA |
| title_short | Assessment of second primary malignancies among treated and untreated patients with chronic lymphocytic leukemia using real-world data from the USA |
| title_sort | assessment of second primary malignancies among treated and untreated patients with chronic lymphocytic leukemia using real world data from the usa |
| topic | chronic lymphocytic leukemia management real-world second primary malignancies treatment |
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