PCN184 - Treatment Patterns of Chronic Lymphocytic Leukemia Patients Under the Brazilian Public Health Care Perspective

Abstract

To identify the chemotherapeutic treatment patterns in patients with chronic lymphocytic leukemia (CLL) treated in the Brazilian Public Healthcare System. A retrospective longitudinal analysis based on Government administrative claims database (Datasus) was performed from January 2008 to December 2012. Eligibility criteria were patients with CLL (ICD code C911) diagnosed until January 2012 and starting their first chemotherapy regimen from January 2008 to January 2012. This cohort of patients was followed until December 2012, death or loss of follow-up. Patients without interruption during treatment and without change in medication were considered in the same chemotherapy regimen. Descriptive statistics (average, standard deviation and percentage) of treatment regimens, treatment free interval (TFI), age at treatment start, gender and length of treatment were performed. A total of 1,538 patients with CLL representing 15,371 APACs (Authorization for High Complexity Procedures) met eligibility criteria. The population cohort comprised 56.6% men with an average age of 67.4±12.1 years. 55.0% of the patients had only one chemotherapy regimen, whereas 44.9% had two and 19.4% had three or more chemotherapy regimens. Time between diagnosis and beginning of treatment was 4.3±7.6 months. The most widely used first chemotherapy regimen was chlorambucil (54.9%), followed by cyclophosphamide, vincristine and prednisolone (CVP) (9.1%), fludarabine and cyclophosfamide (FC) (8.1%) and chlorambucil and prednisone (7.0%). Average length of treatment was 6.3±5.7 months. For second chemotherapy scheme, the most widely used regimen was chlorambucil (45.3%), followed by FC (11.0%), CVP (7.8%), chlorambucil and prednisone (6.2%) and CHOP (3.5%). The average length of treatment was 4.9±3.6 months, with an average TFI of 3.5±5.0 months. Chlorambucil was the most used therapy as both first and second chemotherapy regimen. There was a decreasing of Chlorambucil and an increasing of FC in second scheme. The length of treatment was longer in first scheme.