SOHO 2021: Understanding Clinical Outcomes in Patients With CLL Older Than 80
Posted: Monday, September 20, 2021
A group of researchers compiled information regarding the clinical characteristics of patients older than age 80 with chronic lymphocytic leukemia (CLL), a population that is not often enrolled in clinical trials. Paul Hampel, MD, of the Mayo Clinic, in Rochester, Minnesota, presented these results on behalf of his colleagues during the 2021 Society of Hematologic Oncology (SOHO) Annual Meeting (Abstract CLL-376).
“The 20% higher risk of death compared to an age- and sex-matched population emphasize the need for ongoing efforts to improve clinical outcomes for CLL patients in this growing demographic,” the investigators concluded.
Researchers identified 213 patients from the Mayo Clinic CLL database who were older than 80 at the time of diagnosis. Baseline characteristics, treatments, and time to first treatment were analyzed for all identified patients. The median age among this population was 83, and patients had a median number of four comorbidities. Among the 56 patients who received therapy, the median time to first treatment was 6.7 years. Patients received monoclonal antibodies alone (n = 17), chemotherapy alone (n = 17), chemoimmunotherapy (n = 14), novel agents (n = 3), and multiagent Richter’s transformation regimens (n = 5). In addition, 22 patients received a second-line therapy after a median of 2.8 years.
The median overall survival in the full study population was 4.6 years. Univariate analysis identified factors such as receipt of therapy (hazard ratio = 3.92), age (per 5-year increase hazard ratio = 1.84), and unmutated IGHV (hazard ratio = 2.03) as predictors of a shorter overall survival. To account for potential survival differences among patients receiving novel therapies, survival rates were compared among different groups starting treatment (1995–2001, 2002–2013, and 2014–2020). Although the overall survival rates were similar among these different time periods, the number of patients treated with novel agents was low, necessitating further evaluation.
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