Background: This monocentric retrospective study describes the treatment patterns and outcomes of chronic lymphocytic leukemia (CLL) patients. Methods: Adult CLL patients treated between 1992 and 2022 were included. The time to next treatment (TTNT) was defined as the time from the treatment’s start to the start of a subsequent therapy or death. The time to next treatment failure or death (TTNTF) was defined as the time from treatment discontinuation to the discontinuation of a subsequent therapy or death. Results: Of 637 registered patients, 318 (49.9%) received treatment. We evaluated 157 cBTKi-exposed, 34 BCL2i-exposed cBTKi-naïve, and 26 double-exposed patients. The five-year TTNT values in the cBTKi-exposed patients were 80% (median NR), 40% (median 40 months), and 21% (median 24 months) months in the first line (1L), second line (2L), and beyond the second line (>2L), respectively (p< 0.0001). The five-year TTNT values in the BCL2i-exposed patients were 83% (median NR), 72% (median NR), 12% (median 28 months) in the 1L, 2L, and >2L, respectively (p= 0.185). The median TTNTF was 9 months (range 1–87) after cBTKi and 17 months (range 8–49) after both a cBTKi and BCL2i. Conclusions: This study suggests that, in CLL patients, the earlier we used targeted therapies, the better was the outcome obtained. Nonetheless, the poor outcomes in the advanced lines of therapy highlight the need for more effective treatments.
背景：本单中心回顾性研究描述了慢性淋巴细胞白血病（CLL）患者的治疗模式与临床结局。方法：研究纳入1992年至2022年间接受治疗的成年CLL患者。至下次治疗时间（TTNT）定义为从治疗开始至后续治疗开始或死亡的时间；至下次治疗失败或死亡时间（TTNTF）定义为从治疗中止至后续治疗中止或死亡的时间。结果：在637例登记患者中，318例（49.9%）接受了治疗。我们评估了157例cBTKi暴露患者、34例BCL2i暴露且cBTKi初治患者，以及26例双重暴露患者。cBTKi暴露患者的一线（1L）、二线（2L）及二线以上（>2L）治疗的五年TTNT值分别为80%（中位数未达到）、40%（中位数40个月）和21%（中位数24个月）（p<0.0001）。BCL2i暴露患者的1L、2L及>2L治疗的五年TTNT值分别为83%（中位数未达到）、72%（中位数未达到）和12%（中位数28个月）（p=0.185）。cBTKi治疗后的中位TTNTF为9个月（范围1-87），cBTKi与BCL2i联合治疗后的中位TTNTF为17个月（范围8-49）。结论：本研究提示，在CLL患者中，靶向治疗启用越早，临床结局越好。然而，后线治疗的不良结局凸显了对更有效治疗方案的迫切需求。
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