Real-World Treatment Patterns in Patients with Chronic Lymphocytic Leukemia in Spain: A Retrospective, Cross-Sectional Database Study

Background/Objectives: This study describes demographic and clinical characteristics and treatment patterns (including sequencing) in patients with chronic lymphocytic leukemia (CLL) in Spain. Methods: A retrospective, multicenter, cross-sectional study analyzed 1128 adults with CLL receiving treatment in Spain (2022–2023), using two IQVIA databases. Descriptive statistics were applied. Results: Overall, 71.2% of patients were aged >65 years, 59.9% were male, and 86.1% had an ECOG performance status of 0–1. Common comorbidities included diabetes (25.3%) and cardiac dysfunction/atrial fibrillation (23.1%). More than 98% were tested for del(17p)/TP53 and IGHV mutation status. Covalent BTK inhibitors (cBTKis) predominated across treatment lines (first line: 81%; second: 67%; ≥third: 53%), with ibrutinib most frequent in every line (52%, 46%, and 26%, respectively). Venetoclax-based regimens ranked second (first: 15%; second: 30%; ≥third: 45%). In the first line, cBTKi use was highest among patients with del(17p)/TP53 mutations (92.5%). In the second line, 75% of prior cBTKi users switched to venetoclax-based therapy, while 85% without prior cBTKi received it. Disease progression and adverse effects were the main reasons for cBTKi discontinuation. Conclusions: In Spain, cBTKis predominate in CLL management. Findings indicate high uptake of genetic testing and treatment patterns broadly consistent with contemporary guidelines and highlight the importance of personalised strategies that consider high-risk genetic markers and patient comorbidities.