The following article features coverage from the American Society of Hematology 2019 meeting. Click here to read more of Cancer Therapy Advisor‘s conference coverage.

A real-world examination of adverse events in Medicare patients with chronic lymphocytic leukemia (CLL) showed that the real-world incidence of several hematologic and nonhematologic adverse events was higher than what was reported in noted clinical trials.

These results highlight “potentially greater susceptibility to these adverse events and an unmet medical need in Medicare patients with CLL treated in routine practice,” according to the researchers, who presented this analysis at the 61st American Society of Hematology (ASH) Annual Meeting and Exposition in Orlando, Florida.

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The study looked at data from Medicare claims on patients with CLL who received 1 or more therapies between 2013 and 2015. Patients had to be diagnosed within this window and have had 12 months continuous Medicare enrollment.

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In all, 7965 patients were included. Among these patients, ibrutinib monotherapy was the most frequently used regimen (2033 individuals), followed by “other” (2020 individuals), chlorambucil (1539 individuals), and bendamustine/rituximab (1485 individuals), and rituximab (1063).

Overall, data indicated more frequent occurrence of several hematologic and nonhematologic adverse events.

In addition, there appeared to be a substantial economic burden in the period after initiation of treatment for CLL, the researchers found.

“The mean per-patient per-month (PPPM) costs were $1865 (SD [standard deviation],  $2347) during the baseline period and $8798 (SD, $11,063) after initiation of the first observed CLL-directed systemic therapy (encompassing all observed lines).

Additionally, the average monthly costs increased as adverse events increased. Among patients with 1 to 2 adverse events the average all-cause costs were approximately $5000, but among those with 6 or more adverse events this almost doubled to nearly $10,000.

Overall, two-thirds of patients survived 2 years or longer after the start of the first observed therapy during the study period. Twenty-four month overall survival rates were approximately 69% for ibrutinib, 68% for chlorambucil, 79% for bendamustine/rituximab, and 74% for rituximab alone.

Disclosure: Some of the authors disclosed financial relationships with the pharmaceutical industry. For a full list of disclosures, please refer to the original abstract.

Read more of Cancer Therapy Advisor‘s coverage of ASH’s annual meeting by visiting the conference page.


Goyal RK, Nagar SP, Kabadi SM, et al. Overall survival, adverse events, and economic burden in Medicare patients with chronic lymphocytic leukemia receiving cancer-directed therapy. Presented at: 61st American Society of Hematology (ASH) Annual Meeting and Exposition; December 7-10, 2019; Orlando, FL. Abstract 796.