Ranti Juha, Perkonoja Katariina, Kauko Tommi, Loponen Heidi, Joensuu Emmi I, Järvinen Tiina M
Department of Hematology and Stem Cell Transplantation Unit Division of Medicine Turku University Hospital Turku Finland.
Auria Clinical Informatics Turku University Hospital, Hospital District of Southwest Finland Turku Finland.
EJHaem. 2021 Nov 21;3(1):291-300. doi: 10.1002/jha2.322. eCollection 2022 Feb.
We conducted this retrospective study to characterize the change in chronic lymphocytic leukemia (CLL) treatment patterns between 2005 and 2019, to understand the treatment sequencing across the course of the disease, and to investigate how targeted agents and prognostic testing were implemented into the patient care.
This study included adult patients with CLL treated at the Hospital District of Southwest Finland during the study period. Data were collected from the Turku University Hospital data lake.
In total, 122 and 60 patients received first- and second-line treatments for CLL, respectively. The shift from conventional chemoimmunotherapy to targeted treatments in recent years (2014-2019) was observed. The median overall survival times were not reached in patients treated with targeted agents compared to conventional standard treatments in first- and second-line settings and improved toward the end of the study period. Prognostic testing increased during the study follow-up and patients with unmutated immunoglobulin heavy-chain variable showed significantly poorer overall survival and time-to-next-treatment outcomes than patients with mutated immunoglobulin heavy-chain variable.
This real-world study implicated added value of targeted chemo-free therapies as reported in randomized clinical trials, and highlighted the necessity of prognostic testing in order to improve treatment selection and patient outcomes.
我们开展这项回顾性研究，以描述2005年至2019年间慢性淋巴细胞白血病（CLL）治疗模式的变化，了解疾病进程中的治疗顺序，并研究靶向药物和预后检测如何应用于患者护理。
本研究纳入了研究期间在芬兰西南部医院区接受治疗的成年CLL患者。数据从图尔库大学医院数据湖中收集。
共有122例和60例患者分别接受了CLL的一线和二线治疗。观察到近年来（2014 - 2019年）从传统化疗免疫疗法向靶向治疗的转变。在一线和二线治疗中，与传统标准治疗相比，接受靶向药物治疗的患者未达到中位总生存时间，且在研究期结束时有所改善。在研究随访期间，预后检测有所增加，免疫球蛋白重链可变区未突变的患者的总生存和下次治疗时间结果明显比免疫球蛋白重链可变区突变的患者差。
这项真实世界研究表明了随机临床试验中报道的无化疗靶向治疗的附加价值，并强调了预后检测对于改善治疗选择和患者结局的必要性。
