Reasons for initiation of treatment and predictors of response for patients with Rai stage 0/1 chronic lymphocytic leukemia (CLL) receiving first-line therapy

an analysis of the Connect® CLL cohort study

Christopher R. Flowers, Chadi Nabhan, Neil Elliot Kay, Anthony Mato, Nicole Lamanna, Charles M. Farber, Matthew S. Davids, Pavel Kiselev, Arlene S. Swern, Kristen Sullivan, E. Dawn Flick, Jeff P. Sharman

Research output: Contribution to journalArticle

Abstract

A ‘watch-and-wait’ strategy is recommended for most patients with early-stage chronic lymphocytic leukemia (CLL) prior to treatment initiation. In the Connect® CLL registry, a prospective observational cohort study of 1494 patients treated in 199 US centers, median time to first-line treatment initiation was 3.8, 1.5, and 0.6 years for patients with Rai stage 0, 1, and ≥2, respectively. Only 60% of patients with Rai stage 0/1 underwent FISH/cytogenetic testing prior to initiation of a new line of therapy. Lymphocytosis and lymphadenopathy were the most common reasons for treatment initiation. Lymphocytosis as a reason for treatment initiation was associated with inferior event-free survival at Rai stage 0/1. Short treatment duration was associated with inferior overall survival regardless of Rai stage; sensitivity analyses confirmed the association. The Connect CLL registry provides valuable information on a real-world population of patients with CLL, clarifying both the timing and rationale for initiating therapy.

Original languageEnglish (US)
Pages (from-to)1-9
Number of pages9
JournalLeukemia and Lymphoma
DOIs
StateAccepted/In press - Feb 9 2018

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B-Cell Chronic Lymphocytic Leukemia
Cohort Studies
Lymphocytosis
Therapeutics
Registries
Cytogenetics
Disease-Free Survival
Observational Studies
Survival
Population

Keywords

  • Chronic lymphocytic leukemia
  • Rai staging
  • registry
  • treatment initiation

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

Cite this

Reasons for initiation of treatment and predictors of response for patients with Rai stage 0/1 chronic lymphocytic leukemia (CLL) receiving first-line therapy : an analysis of the Connect® CLL cohort study. / Flowers, Christopher R.; Nabhan, Chadi; Kay, Neil Elliot; Mato, Anthony; Lamanna, Nicole; Farber, Charles M.; Davids, Matthew S.; Kiselev, Pavel; Swern, Arlene S.; Sullivan, Kristen; Flick, E. Dawn; Sharman, Jeff P.

In: Leukemia and Lymphoma, 09.02.2018, p. 1-9.

Research output: Contribution to journalArticle

Flowers, Christopher R. ; Nabhan, Chadi ; Kay, Neil Elliot ; Mato, Anthony ; Lamanna, Nicole ; Farber, Charles M. ; Davids, Matthew S. ; Kiselev, Pavel ; Swern, Arlene S. ; Sullivan, Kristen ; Flick, E. Dawn ; Sharman, Jeff P. / Reasons for initiation of treatment and predictors of response for patients with Rai stage 0/1 chronic lymphocytic leukemia (CLL) receiving first-line therapy : an analysis of the Connect® CLL cohort study. In: Leukemia and Lymphoma. 2018 ; pp. 1-9.
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