OBJECTIVES

: To report real-world data (RWD) of patient, disease characteristics and treatment patterns of CLL in Greece.

METHODS

: We evaluated RWD from the CLL-Database managed by INAB|CERTH. To avoid biases due to the inclusion in the CLL-Database of selected cases from smaller hospitals, we focused on consecutive cases diagnosed between 2006-2018 in Thessaloniki, representing ~10% of the total population of Greece. Data was summarized by descriptive statistics.

RESULTS

: Overall, 1431 patients (males/females:920/511) were evaluated, with a median age of 69 years (28-90): 77.3%, 14.5% and 8.2% were classified as Binet A, B and C, respectively. Of these, 965 concerned Thessaloniki cases. Amongst the latter, 44% had not received any treatment, while 23%, 17% and 16% had received 1, 2 and ≥3 prior lines of therapy (Tx), respectively: median CIRS (cumulative index rating score) values prior to 1^st, 2^nd and ≥3^rd Tx line were 5 (0-16), 7 (0-14) and 7 (0-14), respectively. 60% and 40% of patients, respectively, carried mutated or unmutated IGHV genes. TP53 aberrations [del(17p) and/or TP53 mutations, the latter systematically screened only after 2012] before 1^st, 2^nd and ≥3^rd Tx line were detected in 15.1%, 32.7% and 43.5% of cases, respectively; isolated del(11q) (assessed only before 1^st Tx line) was present in 8.9% of cases. Five-year age-standardized overall survival for patients diagnosed between 2006-2013 was 81.9%. Treatment patterns were assessed for A: 2006-2015 and B: 2015-2018: (i) 1^st line: chemoimmunotherapy (fludarabine-cyclophosphamide-rituximab, anti-CD20+chlorambucil, anti-CD20+bendamustine) use declined from 87.4% in period A to 71.4% in period B; instead, ibrutinib use increased from <0.5% in period A to 22.1% in period B; (ii) 2^nd line: ibrutinib use increased from 8.8% in period A to 52.5% in period B; (iii) 3^rd line: ibrutinib use increased from 6.6% to 33.2% in period B.

CONCLUSIONS

: RWD are critical for population-based CLL research in Greece.