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@article{2238005,
author = {Kosa, Fruzsina and Nečasová, Tereza and Spacek, Martin and Giannopoulos, Krzysztof and Hus, Iwona and Jurková, Tereza and Koriťáková, Eva and Chrápavá, Marika and Novackova, Martina and Katinová, Ivana and Krejčí, Denisa and Jujka, Adam and Matrai, Zoltan and ValyiandNagy, Istvan and Robak, Tadeusz and Doubek, Michael},
article_location = {Hoboken},
article_number = {2},
doi = {http://dx.doi.org/10.1002/cam4.5033},
keywords = {CLL population; FCR therapy; secondary malignancy; survival},
language = {eng},
issn = {2045-7634},
journal = {Cancer Medicine},
title = {Secondary malignancies and survival of FCR-treated patients with chronic lymphocytic leukemia in Central Europe},
url = {https://onlinelibrary.wiley.com/doi/10.1002/cam4.5033},
volume = {12},
year = {2023}
}
TY - JOUR
ID - 2238005
AU - Kosa, Fruzsina - Nečasová, Tereza - Spacek, Martin - Giannopoulos, Krzysztof - Hus, Iwona - Jurková, Tereza - Koriťáková, Eva - Chrápavá, Marika - Novackova, Martina - Katinová, Ivana - Krejčí, Denisa - Jujka, Adam - Matrai, Zoltan - Valyi-Nagy, Istvan - Robak, Tadeusz - Doubek, Michael
PY - 2023
TI - Secondary malignancies and survival of FCR-treated patients with chronic lymphocytic leukemia in Central Europe
JF - Cancer Medicine
VL - 12
IS - 2
SP - 1961-1971
EP - 1961-1971
PB - John Wiley & Sons Ltd.
SN - 20457634
KW - CLL population
KW - FCR therapy
KW - secondary malignancy
KW - survival
UR - https://onlinelibrary.wiley.com/doi/10.1002/cam4.5033
N2 - This is the first large-scale cross-country analysis of patients with chronic lymphocytic leukemia (CLL) aimed to evaluate the incidence, types, and key prognostic factors of secondary malignancies, and to assess the impact on overall survival based on retrospective claims data from three Central European countries. We analyzed 25,814 newly diagnosed CLL patients from Czechia, Hungary, and Poland; 10,312 (39.9%) patients were treated for CLL in study periods between 2004 and 2016. Out of the treated patients, 1986 (19.3%) received the FCR therapy in the first line and 779 (7.6%) received FCR in subsequent lines. We observed that 33.7% of treated patients developed secondary malignancies during the study. Based on country estimates, the probability to develop a secondary malignancy within 4 years since starting the first-line FCR therapy ranged between 28.0% and 36.8%. We found the age at diagnosis, male gender, any malignancy prior to the CLL diagnosis, and the CLL treatment to be the key risk factors for developing secondary malignancies. Specifically, the FCR therapy was a statistically significant (p < 0.001) prognostic factor for risk increase with the hazard ratio between 1.46 and 1.60. Across the three Central European countries, we observed consistent results indicating FCR increased the risk of secondary malignancies in CLL patients. We conclude that secondary malignancies are clearly an undervalued burden for CLL patients, caregivers, and the healthcare system. When evaluating new therapies in regulatory and reimbursement decision making, the factor of secondary malignancies deserves deeper considerations.
ER -
KOSA, Fruzsina, Tereza NEČASOVÁ, Martin SPACEK, Krzysztof GIANNOPOULOS, Iwona HUS, Tereza JURKOVÁ, Eva KORIŤÁKOVÁ, Marika CHRÁPAVÁ, Martina NOVACKOVA, Ivana KATINOVÁ, Denisa KREJČÍ, Adam JUJKA, Zoltan MATRAI, Istvan VALYI-NAGY, Tadeusz ROBAK and Michael DOUBEK. Secondary malignancies and survival of FCR-treated patients with chronic lymphocytic leukemia in Central Europe. \textit{Cancer Medicine}. Hoboken: John Wiley \&{} Sons Ltd., 2023, vol.~12, No~2, p.~1961-1971. ISSN~2045-7634. Available from: https://dx.doi.org/10.1002/cam4.5033.
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