OBJECTIVES: In the US, the incidence of chronic lymphocytic leukemia (CLL) has been increased due to improved survival, therefore a comprehensive understanding of CLL burden is needed for future disease management. A targeted literature review was conducted to identify the published evidence on the epidemiology, clinical, humanistic, and the economic burden associated with CLL in the US.

METHODS: Literature search from recent years (2017-2022) was performed in EMBASE^®, and MEDLINE^® databases. Studies published in the English language reporting on epidemiology and burden associated with CLL patients were included.

RESULTS: Thirty studies were identified from 2,363 citations, with majority reported economic burden (n=13), followed by epidemiology (n=12), clinical burden (n=8), and humanistic burden (n=1). Based on SEER data, the rate of new cases of CLL was 4.7 per 100,000 per year (from SEER 12), and 5-year relative survival was 87.9% (from SEER 17 2012-2018). Comorbidities had a larger impact on survival in patients aged <65 years compared to ≥65 years, while CLL and CLL-related complications (infections and second cancers) were the increased cause of death in CLL patients. Goyal et al. reported that higher baseline cancer-specific stress (measured by the Impact of Event Scale – Revised) associated with poorer 5-month psychological functioning but not physical in relapsed/refractory CLL patients. CLL imposed a high economic burden associated with inpatient, pharmaceutical, adverse events, and indirect costs. Oral targeted therapies are projected to increase the lifetime cost of CLL treatment from $147,000 (in 2011) to $604,000 (by 2025).

CONCLUSIONS: CLL is one of the most frequent types of leukemia, typically occurs in elderly patients. This literature review summarized the available literature and found that increase in incidence and survival in CLL patients and CLL can impose a high economic burden on patients and payers; however, evidence gaps related to the humanistic burden remain.