Survival Outcomes of Patients with Relapsed/Refractory Chronic Lymphocytic Leukemia (CLL) Treated in the Chemoimmunotherapy Vs BTK Inhibitor (BTKi) Eras: A European Research Initiative on CLL (ERIC) Study

C, T

Oral and Poster Abstracts
642. Chronic Lymphocytic Leukemia: Clinical and Epidemiological: Poster III

Research, Lymphoid Leukemias, CLL, Clinical Research, Diseases, Real-world evidence, Lymphoid Malignancies

T C¹^*, Eva Minga²^*, Georgios Karakatsoulis²^*, Elisa Albi³^*, Miguel Alcoceba⁴^*, David Allsup⁵^*, Francesca Bacchiarri, MD⁶^*, Sotiria Besikli-Dimou²^*, Sofia Chatzileontiadou⁷^*, Rosa Collado⁸^*, Zadie Davis⁹^*, Maria Dimou, MD¹⁰^*, David Donaldson¹¹^*, Maria Efstathopoulou¹²^*, Sara Galimberti, MD¹³^*, Andrea Galitzia, MD¹⁴^*, Eva Gimeno¹⁵^*, Valerio Guarente, MD¹⁶^*, Eleftheria Hatzimichael, MD, PhD¹⁷^*, Jose-Angel Hernandez-Rivas¹⁸^*, Gloria Iacoboni, MD¹⁹^*, Iliana Konstantinou²⁰^*, Ioannis Kotsianidis²¹^*, Jana Kotaskova²²^*, Andreas Epameinondas Koumpis²³^*, Zuzana Kubova, MD²⁴^*, Jorge Labrador, MD²⁵^*, Luca Laurenti, MD^26,27^*, Juan Marquet, MD²⁸^*, Stanislava Maslejova, MD²²^*, Carlota Mayor-Bastida²⁹^*, Fatima Miras³⁰^*, Riccardo Moia, MD³¹^*, Almudena Navarro-Bailon³²^*, Jacopo Olivieri, MD, PhD³³^*, Maria Papaioannou⁷^*, Anna Puiggros, PhD³⁴^*, Gian Matteo Rigolin³⁵^*, Mattia Schipani³⁶^*, Tereza Shokralla³⁷^*, Martin Simkovic³⁸^*, Antigoni Tranidou¹^*, Theodoros Vassilakopoulos¹⁰^*, Andrea Visentin³⁹^*, Candida Vitale, MD, PhD⁴⁰^*, George Vrachiolias⁴¹^*, Renata Walewska, MD, PhD⁴²^*, Lucrecia Yanez San Segundo^43,44^*, Jana Zuchnicka⁴⁵^*, David Graham Oscier⁴², Alessandro Gozzetti⁴⁶^*, Panayiotis Panayiotidis, MD¹⁰, Francesc Bosch, MD, PhD⁴⁷, Paolo Sportoletti, BSc¹⁶^*, Blanca Espinet, PhD³⁴^*, Gerassimos Pangalis, MD⁴⁸^*, Maria Angelopoulou¹⁰^*, Tomas Papajik, MD, PhD⁴⁹^*, Roberta Murru⁵⁰^*, Marta Coscia, MD, PhD⁴⁰^*, Antonio Cuneo, MD⁵¹^*, Gianluca Gaidano, MD, PhD³⁶, Niki Stavrogianni, MD⁵²^*, Livio Trentin⁵³, Lukas Smolej³⁸^*, Mark Caterwood¹¹^*, Martin Spacek⁵⁴^*, Sarka Pospisilova, Prof⁵⁵^*, Michael Doubek, Prof⁵⁵, Anastasia Chatzidimitriou²^*, Kostas Stamatopoulos²^*, Paolo Ghia, MD, PhD^56,57 and Lydia Scarfo, MD^3,58

¹Institute of Applied Biosciences, Centre for Research and Technology Hellas, Thessaloniki, Greece, Thessaloniki, Greece
²Institute of Applied Biosciences, Centre for Research and Technology Hellas, Thessaloniki, Greece
³Strategic Research Program on CLL, IRCCS Ospedale San Raffaele, Milano, Italy
⁴Hospital Universitario de Salamanca. (HUS/IBSAL), CIBERONC, and Centro de Investigación del Cáncer (CIC/USAL, Salamanca, Spain
⁵Hull York Medical School, Hull, United Kingdom
⁶Division of Hematology, University of Siena, Siena, ITA
⁷1st Department of Internal Medicine, AHEPA University Hospital of Thessaloniki, Thessaloniki, Greece
⁸Hospital Clínico Universitario de Valencia, Instituto de Investigación Sanitaria INCLIVA, Valencia, ESP
⁹Molecular Pathology, University Hospitals Dorset, Royal Bournemouth Hospital, Bournemouth, United Kingdom
¹⁰Department of Hematology and Bone Marrow transplantation Unit, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
¹¹Haematology Department, Belfast City Hospital, Belfast, United Kingdom
¹²Department of Haematology Athens Medical Center-Psychikon Branch, Athens, Greece
¹³Department of Clinical and Experimental Medicine, Hematology, University of Pisa, Pisa, Italy
¹⁴Hematology and Stem Cell Transplantation Unit, Ospedale San Francesco, Hematology and Stem Cell Transplantation Unit, Ospedale San Francesco, Nuoro, Italy
¹⁵Department of Hematology, Hospital del Mar, Barcelona, Spain
¹⁶Institute of Hematology and Center for Hemato-Oncology Research, University of Perugia and Santa Maria della Misericordia Hospital, Perugia, Italy
¹⁷Department of Hematology, Faculty of Medicine, University of Ioannina, Ioannina, Greece
¹⁸Hematology Department Infanta Leonor University Hospital, Madrid, Spain
¹⁹Hospital Universitari Vall d’Hebron-Universitat Autónoma de Barcelona, SEATTLE, WA
²⁰Department of Haematology, University of Athens, Laikon General Hospital, Athens, Athens, Greece
²¹Department of Hematology, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
²²Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech Republic
²³Department of Haematology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
²⁴Department of Hemato-Oncology, Faculty of Medicine and Dentistry, Palacký University and University Hospital Olomouc, Olomouc, Czech Republic
²⁵Department of Hematology, Hospital Universitario de Burgos, Universidad Isabel I, Burgos, Spain
²⁶Department of Diagnostic Imaging, Oncological Radiotherapy and Hematology, Agostino Gemelli University Hospital Foundation IRCCS, Rome, Italy
²⁷Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Roma, Università Cattolica del Sacro Cuore, Rome, Italy
²⁸Hematology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
²⁹Haematology Department, Hospital Universitario de La Princesa, Madrid, Spain
³⁰Hematology Department Hospital Universitario 12 de Octubre, Madrid, Spain
³¹Division of Hematology, Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy
³²Hematology Department, IBSAL-University Hospital of Salamanca. University of Salamanca., Salamanca, Spain
³³Hematology Clinic, ASUFC, Udine, Italy
³⁴Molecular Cytogenetics Laboratory, Pathology Department, Hospital del Mar and Translational Research on Hematological Neoplasms Group, Hospital del Mar Research Institute (IMIM), Barcelona, Spain
³⁵Hematology Section, St. Anna University Hospital, Ferrara, Italy
³⁶Division of Hematology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
³⁷1st Department of Medicine - Hematology, First Faculty of Medicine, Charles University and General Hospital in Prague, Prague, Czech Republic
³⁸4th Department of Internal Medicine – Haematology, Faculty of Medicine in Hradec Kralove, University Hospital and Charles University in Prague, Hradec Kralove, Czech Republic
³⁹Hematology Unit, Department of Medicine, University of Padova, Padova, ITA
⁴⁰Division of Hematology, A.O.U. Città della Salute e della Scienza di Torino and Department of Molecular Biotechnology and Health Sciences, University of Torino, Turin, Italy
⁴¹Democritus University of Thrace, Department of Hematology, University Hospital of Alexandroupolis, Alexandroupolis, Greece, Alexandroupolis, Greece
⁴²Department of Haematology, Royal Bournemouth Hospital, Bournemouth, United Kingdom
⁴³University Hospital MarquéS De Valdecilla - IDIVAL, Santander, Spain
⁴⁴Department of Hematology, University Hospital Marqués de Valdecilla, Santander, Spain
⁴⁵Department of Hematooncology, University Hospital Ostrava, Ostrava, Czech Republic
⁴⁶Division of Hematology, University of Siena, Siena, Italy
⁴⁷Hematology Department, Vall d’Hebron Institute of Oncology (VHIO), University Hospital Vall d’Hebron, Barcelona, Spain
⁴⁸Department of Haematology, Psychicon Branch, Athens Medical Center, Athens, Greece
⁴⁹Department of Hemato-Oncology, Faculty of Medicine and Dentistry, Palacky University and University Hospital, Olomouc, Czech Republic
⁵⁰Hematology and Stem Cell Transplantation Unit, Ospedale Oncologico A. Businco, ARNAS "G. Brotzu", Cagliari, Italy
⁵¹Division of Hematology, University of Ferrara, Ferrara, Ferrara, Italy
⁵²Hematology Department and HCT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
⁵³Hematology Unit, Department of Medicine, University of Padova, Padova, Italy
⁵⁴1st Department of Medicine - Haematology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
⁵⁵Department of Internal Medicine – Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
⁵⁶IRCCS Ospedale San Raffaele, Milan, Italy
⁵⁷Università Vita-Salute San Raffaele, Milano, Italy
⁵⁸Medical School, Università Vita-Salute San Raffaele, Milano, Italy

Introduction:

The introduction of targeted agents has radically changed the management of patients with chronic lymphocytic leukemia (CLL). Randomized controlled trials have shown the superiority of targeted agents over chemoimmunotherapy (CIT) in patients with relapsed/refractory (R/R) CLL. Following these trials, the treatment paradigm of CLL in daily practice shifted from CIT to targeted agents in any line of treatment. However, it is largely unknown if this has improved the overall survival (OS) of patients with R/R CLL in the real world.

Methods:

This is a retrospective, observational study that aimed to explore differences in the OS of patients with CLL in a real-world setting.

Patients who received second-line treatment for CLL between 2010 and 2019 in five European countries (Czech Republic, Greece, Italy, Spain, and the United Kingdom) were eligible for the study. The patients were allocated to two different groups (CIT-era and BTKi-era groups) according to the actual use of BTKis in R/R settings in each country.

The year when the use of BTKis surpassed 30% in any line was defined as the cutoff year for each country. Cases treated before the cutoff year were allocated to the CIT-era group, and cases treated after the cutoff year were allocated to the BTKi-era group.

We compared the OS from the initial date of second line treatment between the two groups. The analysis was also done after adjusting for age at second line treatment through propensity score matching.

Results:

A total of 1877 patients (1384 in the CIT-era group and 493 in the BTKi-era group) from 38 centers were eligible for the study. The cutoff year was 2019, 2018, 2017, 2016, and 2014 for the Czech Republic, Greece, Italy, Spain, and the United Kingdom, respectively. In both groups, most patients were males [919 (66.4%) in the CIT-era and 337 (68.4%) in the BTKi-era group, p=0.461]. Patients in the CIT-era group were younger at both diagnosis [64 years (interquartile range (IQR)=57-71) vs 66 (IQR=59-74), p=0.001 for CIT-era and BTKi-era groups, respectively] and the start of second-line treatment [69 years (IQR=63-76) vs 73 (IQR=65, 79) p=0.001 for the CIT-era and BTKi-era groups, respectively]. The CIRS score was higher in the BTKi-era group [3 (IQR=1.25-6) vs 4 (IQR=2-6), p=0.053 for the CIT-era and BTKi-era groups, respectively]. Unfavorable disease biomarkers were similarly distributed among the two groups [del(11q): 215 (27.7%) vs. 80 (24.2%), p=0.26 | del(17p): 117 (14.7%) vs. 54 (15.7%), p=0.7 | TP53 mutations: 94 (19%) vs. 41 (17.3%), p=0.66 | unmutated immunoglobulin heavy variable (IGHV) gene status: 792 (78.8%) vs 276 (76.2%), p=0.35 for the CIT-era and BTKi-era groups, respectively]. The follow-up time from diagnosis (153 months [95% confidence intervals (CI):149-160) vs 106.6 (95% CI:98-115) for CIT-era and BTKi-era groups, respectively] and second-line treatment [81 months (95% CI:77-86) vs 30 (95% CI:27- 33) for CIT-era and BTKi-era groups, respectively] were longer for the CIT-era group.

Patients in the BTKi-era group had statistically significantly better OS compared to the CIT-era group (Hazard ratio (HR): 0.74 95% CI: 0.61-0.91, p=0.003). This difference was even more pronounced when comparing OS using propensity score matching (HR: 0.71, 95% CI: 0.58-0.88, p=0.001). The median OS for the CIT-era group was 65 months (95% CI=57-71), while the median OS for the BTKi-era group was not reached (95% CI=not estimable, not estimable).

Finally, we performed a univariable and multivariable analysis (MVA) to assess the risk factors for death in the entire population. TP53 aberrations and unmutated IGHV gene status remained the only statistically significant risk factors for death in the MVA (HR: 1.7, 95% CI: 1.03-3.13, p=0.039, HR: 2.48, 95% CI: 1.08-5.66, p=0.032, respectively). The only protective factor against death was treatment with BTKis in the R/R setting (HR: 0.5, 95% CI: 0.28-0.88, p=0.017).

Conclusion:

Our findings demonstrated that the availability of BTKis has improved the OS of patients with R/R CLL in the real-world setting.

Disclosures: C: AbbVie: Honoraria. Collado: Janssen-Cilag and S.A.: Other: support for attending meetings. Galimberti: AbbVie: Honoraria, Other: support for attending meetings; AstraZeneca: Honoraria, Other: support for attending meetings; Jazz: Honoraria, Other: support for attending meetings; Novartis: Honoraria, Other: support for attending meetings; Incyte: Honoraria; Roche: Honoraria, Other: support for attending meetings; Celgene: Honoraria; Pfizer: Honoraria; Janssen: Honoraria. Hernandez-Rivas: Janssen: Honoraria, Other: support for attending meetings; AbbVie: Honoraria, Other: support for attending meetings; AstraZeneca: Honoraria, Other: support for attending meetings; Lilly: Honoraria; BeiGene: Honoraria, Other: support for attending meetings. Iacoboni: Autolus, Bristol-Myers Squibb, Kite/Gilead, Miltenyi, Novartis: Consultancy; AbbVie, AstraZeneca, Autolus, Bristol-Myers Squibb, Kite/Gilead, Miltenyi, Novartis, Lilly and Sandoz: Honoraria; Autolus: Consultancy; Kite, a Gilead Company: Consultancy, Honoraria, Other: Travel support; BMS: Consultancy, Honoraria; AbbVie: Honoraria, Other: Travel Support; AstraZeneca: Honoraria, Other: Travel support; Novartis: Honoraria; Miltenyi: Consultancy, Honoraria; AbbVie, AstraZeneca, Kite/Gilead, Miltenyi: Other: Travel support. Kotsianidis: AbbVie: Honoraria, Other: consulting fees; Janssen: Honoraria, Other: consulting fees. Laurenti: AstraZeneca, AbbVie, Johnson and Johnson, BeiGene, Lilly: Membership on an entity's Board of Directors or advisory committees; AstraZeneca, AbbVie: Research Funding; AstraZeneva, AbbVie, Johnson and Johnson, BeiGene, Lilly: Honoraria. Navarro-Bailon: Janssen: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: support for attending meetings; BeiGene: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: support for attending meetings; AbbVie: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: support for attending meetings; AstraZeneca: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: support for attending meetings; Takeda: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: support for attending meetings. Olivieri: AbbVie: Honoraria; AstraZeneca: Honoraria; Janssen: Honoraria. Rigolin: AbbVie: Honoraria, Speakers Bureau; AstraZeneca: Honoraria, Speakers Bureau; BeiGene: Honoraria, Speakers Bureau; Janssen: Honoraria, Other: support for attending meetings, Speakers Bureau. Shokralla: AbbVie: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; Amgen: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; AstraZeneca: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; BeiGene: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; BMS: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; Celgene: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; Gilead: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; GlaxoSmithKline: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; Hoffmann-La Roche: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; Incyte: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; Infinity: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; Novartis: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; Sunesis: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau. Simkovic: Gilead: Current equity holder in publicly-traded company; GSK: Current equity holder in publicly-traded company; Merck: Current equity holder in publicly-traded company; Eli Lilly: Current equity holder in publicly-traded company; Sanofi: Current equity holder in publicly-traded company; Johnson and Johnson: Current equity holder in publicly-traded company; Pfizer: Current equity holder in publicly-traded company; Janssen-Cilag: Honoraria, Other: support for attending meetings; AbbVie: Current equity holder in publicly-traded company, Honoraria, Other: support for attending meetings; AstraZeneca: Current equity holder in publicly-traded company, Honoraria, Other: support for attending meetings. Vitale: AstraZeneca: Honoraria, Other: support for attending meetings; AbbVie: Honoraria; Johnson & Johnson: Honoraria; Takeda: Other: support for attending meetings. Walewska: AbbVie: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: support for attending meetings; AstraZeneca: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: support for attending meetings; BeiGene: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: advisory board fees; Janssen: Membership on an entity's Board of Directors or advisory committees; SecuraBio: Membership on an entity's Board of Directors or advisory committees. Yanez San Segundo: AbbVie: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: support for attending meetings; AstraZeneca: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: support for attending meetings; Novartis: Honoraria; Gilead: Honoraria, Other: support for attending meetings; Janssen: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: support for attending meetings; Jazz: Honoraria, Membership on an entity's Board of Directors or advisory committees; MSD: Honoraria; Pfizer: Honoraria, Other: support for attending meetings; BeiGene: Membership on an entity's Board of Directors or advisory committees; Celgene: Membership on an entity's Board of Directors or advisory committees. Panayiotidis: Roche: Membership on an entity's Board of Directors or advisory committees; AstraZeneca: Membership on an entity's Board of Directors or advisory committees, Research Funding; Novartis: Membership on an entity's Board of Directors or advisory committees; Bristol Myers Squibb: Membership on an entity's Board of Directors or advisory committees; Janssen: Membership on an entity's Board of Directors or advisory committees; AbbVie: Membership on an entity's Board of Directors or advisory committees, Research Funding. Bosch: Lava Therapeutics: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: payment for expert testimony; Advantage Allogene: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: payment for expert testimony; TG Therapeutics: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: payment for expert testimony; Gilead: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: payment for expert testimony; Lilly: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: payment for expert testimony; Mundipharma: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: payment for expert testimony; Janssen: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: payment for expert testimony; Roche: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: payment for expert testimony; AstraZeneca: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: payment for expert testimony; Celgene/BMS: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: payment for expert testimony; Enterome: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: payment for expert testimony; BeiGene: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: payment for expert testimony; Takeda: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: payment for expert testimony; Novartis: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: payment for expert testimony; Genentech: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: payment for expert testimony; AbbVie: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: payment for expert testimony. Angelopoulou: Novartis: Honoraria; Janssen: Membership on an entity's Board of Directors or advisory committees; Roche: Honoraria, Membership on an entity's Board of Directors or advisory committees; Genesis: Honoraria, Membership on an entity's Board of Directors or advisory committees; Gilead: Honoraria, Membership on an entity's Board of Directors or advisory committees; Amgen: Membership on an entity's Board of Directors or advisory committees; AbbVie: Honoraria, Membership on an entity's Board of Directors or advisory committees; Takeda: Honoraria, Membership on an entity's Board of Directors or advisory committees. Papajik: Janssen-Cilag: Honoraria, Membership on an entity's Board of Directors or advisory committees; AbbVie: Honoraria, Membership on an entity's Board of Directors or advisory committees; AstraZeneca: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: support for attending meetings. Coscia: AbbVie: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: support for attending meetings; AstraZeneca: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: support for attending meetings; Janssen: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: support for attending meetings. Cuneo: AbbVie: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: support for attending meetings; AstraZeneca: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: support for attending meetings; BeiGene: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: support for attending meetings; Janssen: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: support for attending meetings; Lilly: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: support for attending meetings. Gaidano: Janssen: Honoraria; Incyte: Honoraria; Hikma: Honoraria; BeiGene: Honoraria; AstraZeneca: Honoraria; Lilly: Honoraria; AbbVie: Honoraria. Stavrogianni: Lilly: Honoraria; AstraZeneca: Honoraria, Other: support for attendig meetings; AbbVie: Honoraria; Janssen: Honoraria, Other: support for attendig meetings. Smolej: AbbVie: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: support for attending meetings; AstraZeneca: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: support for attending meetings; Janssen: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: support for attending meetings. Spacek: Janssen: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: support for attending meetings; AstraZeneca: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: support for attending meetings; AbbVie: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: support for attending meetings. Doubek: Janssen: Honoraria, Research Funding; AstraZeneca: Honoraria, Research Funding; AbbVie: Honoraria, Research Funding. Stamatopoulos: Janssen: Honoraria, Research Funding; Novartis: Research Funding; Roche: Research Funding; Bristol Myers Squibb: Honoraria; Lilly: Honoraria; AstraZeneca: Honoraria, Research Funding; AbbVie: Honoraria, Research Funding. Ghia: AstraZeneca: Consultancy, Research Funding; BeiGen: Consultancy; Bristol Myers Squibb: Consultancy, Research Funding; Johnson&Johnson: Consultancy, Research Funding; Galapagos: Consultancy; Loxo@Lilly: Consultancy; MSD: Consultancy; Galapagos: Consultancy; AbbvVie: Consultancy, Research Funding; Roche: Consultancy. Scarfo: AstraZeneca: Honoraria; AbbVie: Honoraria; BeiGene: Honoraria; Lilly: Honoraria; Janssen: Honoraria; Octapharma: Honoraria.

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4619 Survival Outcomes of Patients with Relapsed/Refractory Chronic Lymphocytic Leukemia (CLL) Treated in the Chemoimmunotherapy Vs BTK Inhibitor (BTKi) Eras: A European Research Initiative on CLL (ERIC) Study