Patient Characteristics and Treatment Patterns in Patients with Chronic Lymphocytic Leukemia in China: A Real-World, Contemporary Cohort Study

OBJECTIVES: To examine the demographic, clinical characteristics, and treatment patterns of patients with Chronic Lymphocytic Leukemia (CLL) in a real-world Chinese cohort.

METHODS: This retrospective study utilized integrated regional electronic healthcare records covering the period from 2004 to 2022. The sample consisted of newly diagnosed CLL patients with continuous healthcare interactions, with the first recorded CLL diagnosis date serving as the index date. Exclusions included individuals under 18 years old and those lacking information on age and sex. Data collection encompassed patient demographics, CLL stage at diagnosis, treatment regimens, and clinical outcomes.

RESULTS: A total of 3665 patients were identified. The median age was 62 years, with a majority being male (60.7%), RAI stage III/IV observed in 27.8%, and 910 (24.8%) having insurance coverage. Patients had an average Charlson Comorbidity Index (CCI) of 1.6 (SD:2.0) during baseline, with the most common comorbid conditions being hypertension (8.9%), pulmonary infection (7.8%), and diabetes (5.9%). Over a median follow-up of 9 [27.6(63.1)] months from the index date, 1500 (41.0%) of patients received CLL-directed treatment, with 856 (57.0%), 343 (22.9%), and 301 (20.0%) undergoing chemotherapy, immunochemotherapy, and targeted therapy in first-line treatment, respectively. Among those receiving targeted therapy, 335 (74.4%), 98 (21.8%), 5 (1.1%), 4 (0.9%), and 8 (1.8%) used ibrutinib, zanubrutinib, orelabrutinib, venetoclax, and lenalidomide. The proportion receiving BTKi increased from 0.3% to 65% between 2017 and 2022. Additionally, 15 (0.4%) and 2 (0.05%) patients underwent stem cell transplantation and CAR-T therapy, respectively. Median overall survival (OS) from initial diagnosis or 1L treatment initiation was not achieved. The 1-year and 3-year survival rates were 95.1% and 88.5% from 1L treatment initiation, and 97.6% and 92.8% from the initial diagnosis.

CONCLUSIONS: In this real-world study using regional healthcare data, distinct demographic, clinical, and tumor-related characteristics were observed, providing a comprehensive overview of CLL management in China.