Korean J Intern Med.
2023 Sep;38(5):747-757. 10.3904/kjim.2022.408.
Treatment pattern of chronic lymphocytic leukemia/small lymphocytic lymphoma in Korea: a multicenter retrospective study (KCSG LY20-06)
- Affiliations
-
- 1Department of Internal Medicine, Chungnam National University Sejong Hospital, Sejong, Korea
- 2Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
- 3Department of Internal Medicine, Inje University Haeundae Paik Hospital, Busan, Korea
- 4Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu, Korea
- 5Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
- 6Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea
- 7Department of Hematology and Medical Oncology, College of Medicine, Kyung Hee University, Seoul, Korea
- 8Division of Hematology and Oncology, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea
- 9Department of Internal Medicine, Inje University Sanggye Paik Hospital, Seoul, Korea
- 10Division of Hematology and Oncology, Department of Internal Medicine, Chosun University Hospital, Gwangju, Korea
- 11Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
- KMID: 2545699
- DOI: http://doi.org/10.3904/kjim.2022.408
Abstract
- Background/Aims
Little attention is paid to chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) in Korea due to the rarity of the disease. With its rising incidence, we aimed to evaluate recent changes in treatment patterns and survival outcomes of patients with CLL/SLL.
Methods
A total of 141 patients diagnosed with CLL/SLL between January 2010 and March 2020 who received systemic therapy were analyzed in this multicenter retrospective study.
Results
The median patient age was 66 years at diagnosis, and 68.1% were male. The median interval from diagnosis to initial treatment was 0.9 months (range: 0–77.6 months), and the most common treatment indication was progressive marrow failure (50.4%). Regarding first-line therapy, 46.8% received fludarabine, cyclophosphamide, plus rituximab (FCR), followed by chlorambucil (19.9%), and obinutuzumab plus chlorambucil (GC) (12.1%). The median progression-free survival (PFS) was 49.3 months (95% confidence interval [CI], 32.7–61.4), and median overall survival was not reached (95% CI, 98.4 mo– not reached). Multivariable analysis revealed younger age (≤ 65 yr) (hazard ratio [HR], 0.46; p < 0.001) and first-line therapy with FCR (HR, 0.64; p = 0.019) were independently associated with improved PFS. TP53 aberrations were observed in 7.0% (4/57) of evaluable patients. Following reimbursement, GC became the most common therapy among patients over 65 years and second in the overall population after 2017.
Conclusions
Age and reimbursement mainly influenced treatment strategies. Greater effort to apply risk stratifications into practice and clinical trials for novel agents could help improve treatment outcomes in Korean patients.
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