Real-world treatment and outcomes among older adults with chronic lymphocytic leukemia before the novel agents era

Real-world treatment and outcomes among older adults with chronic lymphocytic leukemia before the novel agents era Chronic lymphocytic leukemia (CLL) is the most common leukemia among adults in Western countries, with a median age at diagnosis of 70 years.1 Until 2014, chemoimmunotherapy combinations were the mainstay treatment, particularly for physically fit patients.2,3 However, older individuals or those with comorbid conditions may be less likely to tolerate standard CLL chemoimmunotherapy combinations.It is important to establish a baseline understanding of real-world CLL treatments and outcomes prior to the introduction of novel agents, as this would allow for a better understanding of unmet needs, particularly among older patients in the pre-novel therapy era, and also inform future comparative effectiveness studies.4 Current literature provides limited data about real-world treatment patterns and survival among older CLL patients.To address these gaps in the literature, we utilized comprehensive prescription and medical insurance claims linked with cancer registry data to analyze both first-line and second-line treatment patterns as well as survival outcomes in older adults newly diagnosed with CLL, in the time period (2007-2013) that immediately predated FDA approval of novel agents.We also stratified outcomes by age (66-74 "younger seniors" vs. ≥75 years "older seniors").Our retrospective cohort study used 2007-2013 Surveillance, Epidemiology, and End Results (SEER) data linked with Medicare files to compare treatment patterns, time-to-treatment initiation, and overall and CLLspecific survival from first-line and second-line treatments among Medicare beneficiaries aged >65 years who were newly diagnosed with CLL between 2007 and *P-values reflect the results of t-tests.† P-values reflect the results of chi-square tests.#Cells with counts of less than 11 are not reported in compliance with the National Cancer Institute data use agreement.CLL: chronic lymphocytic leukemia.