Session: 905. Outcomes Research—Lymphoid Malignancies: Poster III
Hematology Disease Topics & Pathways:
Lymphoid Leukemias, CLL, Diseases, Lymphoid Malignancies
Methods: Patients with 18 years or older, diagnosed with or treated for CLL between 2005-2022 in centers participating in the GELL were included. Patients treated in clinical trials were excluded.
Results: 470 patients were analyzed from 6 countries (Peru, Mexico, Paraguay, Chile, Venezuela and Uruguay). 78% were treated at private institutions. The median age was 69 years (35-97), and 193 (41%) were women. According to race, 416 (89%) were white, 2 (0.4%) were black, 2 (0.4%) were indigenous, and 50 (11%) were of mixed race. 337 (72%) had ECOG 0-1. Stage distribution was Rai 0: 183 (39%), I: 120 (26%), II: 61 (13%), III: 34 (7%), IV 26 (6%), and unclassified 46 (9%). Regarding prognostic factors: 11% were CD38 positive. B2-microglobulin data were available in 233 patients (49.5%) and in 124 was high (53%), IgVH mutational status in 41 (9%) of whom 27 (6%) were mutated and 14 (3%) were unmutated. 355 (76%) of patients were observed at time of diagnosis. 220 (47%) patient required treatment with median time to first line treatment of 6 months (range 0-204). Among patients who received treatment, 50 (23%) had cytogenetic and 57 (26%) FISH studies performed. Del17p was detected in 5 patients. P53 mutational status was studied in 12 patients, 1 was found mutated. First line treatment was as follows: Chemotherapy: (Chlorambucil +/- prednisone 46 patients, FC 15, CHOP-like 8), Chemoimmunotherapy (FCR 56, R-CHOP-like 40, BR 24, Chlorambucil + AntiCD20 MoAb 17, FR 1), Ibrutinib 9, Venetoclax + Obinutuzumab 3. Treatment strategies according to date of treatment is shown in Figure 1. 146 (78%) of patients who received chemotherapy or chemoimmunotherapy did not have a previous cytogenetic analysis (Figure 2). According to the country, Uruguay 37%, Mexico 74%, Chile 82%, Peru 83%, Paraguay 89% and Venezuela 96% did not have genetic studies before therapy.
Conclusions: Our study shows real-world data in CLL patients from LATAM. The median age at diagnosis is comparable to those reported in developed countries moreover, we report a high percentage of patients with early-stage disease at diagnosis related to the higher diagnosis of asymptomatic patients in routine exams.Most patients treated with chemotherapy or chemoimmunotherapy did not have a cytogenetic testing to guide treatment selection. Also, there are differences in access to cytogenetic testing between the countries analyzed. We show a slight change in treatment patterns in the last years, chemoimmunotherapy remains the most used first line treatment, and a suboptimal access to novel agents is evident. We plan to expand our study cohort with data from the other LATAM countries to have a deeper understanding of the reality of our region and help overcome inequalities.
Disclosures: Oliver: Abbvie: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Agencia Nacional De Investigacion e innovacion: Research Funding; Janssen: Speakers Bureau; Nolver: Membership on an entity's Board of Directors or advisory committees; Roche: Speakers Bureau. Villela Martinez: Roche Mexico: Speakers Bureau; AstraZeneca Mexico: Speakers Bureau; Janssen Mexico: Speakers Bureau; Sanofi Mexico: Speakers Bureau; Asofarma Mexico: Speakers Bureau. Alvarez: Novartis,: Speakers Bureau; AbbVie: Speakers Bureau; Bristol: Speakers Bureau; Janssen: Speakers Bureau; Takeda: Speakers Bureau; Teva: Speakers Bureau. Castillo: Cellectar: Consultancy; AstraZeneca: Research Funding; Beigene: Consultancy, Research Funding; Abbvie: Consultancy, Research Funding; Janssen: Consultancy; Roche: Consultancy; TG Therapeutics: Research Funding; Pharmacyclics: Consultancy, Research Funding.
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