PS1166 LONGITUDINAL TREATMENT PATTERNS AND OUTCOMES OF CHRONIC LYMPHOCYTIC LEUKEMIA IN ISRAEL (2009–2018)

Background: The treatment landscape for chronic lymphocytic leukemia (CLL) is evolving. Recent updates to the Israeli National List of Health Services include fludarabine/rituximab (FR‐based regimen, 2009), bendamustine (2014), obinutuzumab, ofatumumab, ibrutinib (2015) and venetoclax (2017). Aims: To describe treatment patterns and outcomes of CLL patients in a large unselected population. Methods: A retrospective study was conducted using the database of Maccabi Healthcare Services, a 2.2‐million‐member health payer‐provider in Israel. CLL was defined by cross‐linking diagnosis, pharmacy and laboratory data. Newly diagnosed (1999–2017) and treated (2009–2017) patients were followed from first line (L1) through 31/3/2018 for overall survival (OS) and progression to second line (L2). Results: Included were 411 patients; mean (± SD) age was 63.8 (±11.5) years (63.7% male), with a median 2.9 years since diagnosis. Regimens FR‐based, bendamustine/rituximab (BR‐based) and obinutuzumab ± chlorambucil (G‐Clb) accounted for 19.5%, 12.2% 11.4% of L1, respectively. L1 also included chlorambucil monotherapy (22.3%) and rituximab ± chemotherapy other than FR/BR (R ± CT; 27.5%). Median (95% CI) OS was 7.0 (6.3–7.7) years, with 75% of FR‐based patients surviving >5.7 years. Median time to L2 for FR‐based, BR‐based and any L1 was 4.9(3.1–6.7) years, 3.1(1.5–4.7) years and 3.1(2.6–3.6) years, respectively. L2 included 26.6% ibrutinib. Progression to L2 was significantly associated with male sex, older age, lower socioeconomic status, and L1 regimen (chlorambucil or R ± CT vs. FR‐based). Summary/Conclusion: Treated CLL patients survived a median of 7 years and half progressed to L2 within 5 years. These real‐world data are of high importance in the changing treatment landscape of CLL.