Retrospective Look at Therapeutic Considerations for Adolescent and Young Adults With CLL
Posted: Thursday, July 22, 2021
Research presented in the British Journal of Haematology analyzed disease characteristics and outcomes in adolescent and young adults with chronic lymphocytic leukemia (CLL). Nitin Jain, MD, of The University of Texas MD Anderson Cancer Center, Houston, and colleagues noted that it is rare for the disease to present in patients between the ages of 15 and 39 years, contributing to the lack of understanding around outcomes specific to this age group.
“Though adolescent and young adult patients with CLL represent a rare subgroup of CLL, it appears that conclusions from CLL studies and clinical trials can be extrapolated to this population to guide their treatment,” concluded the study authors.
The study included 227 adolescent and young adults who had been diagnosed with CLL within the previous 20 years and evaluated at MD Anderson Medical Center. Overall survival was 90% at 5 years and 78% at 10 years, with a median time to first treatment of 2.2 years. An association was observed between a reduced time to first treatment and shorter overall survival and certain disease characteristics: elevated beta 2-microglobulin levels prior to treatment, advanced Rai stage, del(11q) or del(17p) by fluorescence in situ hybridization, IGHV without mutation, and CD38 positivity. Shorter overall survival was also associated with del(11q) or del(17p) and complex karyotype among patients who had been treated with oral targeted therapy.
The time to second treatment was meaningfully linked with first-line therapy received, according to the study authors. Allogeneic stem cell transplantation was more likely to occur in patients with del(11q) or del(17p). This subgroup also had a decreased time to Richter transformation.
Disclosure: For full disclosures of the study authors, visit onlinelibrary.wiley.com.