PCN41 - Incidence Rates Of Patients Starting Treatment For Chronic Lymphocytic Leukemia In The Brazilian Public Health Care System: A Retrospective Epidemiologic Study Based On Datasus

Abstract

Chronic lymphocytic leukemia (CLL) is the most common type of leukemia in adults. In the US, the numbers of new cases and deaths represent 4.5/100,000 and 1.4/100,000 per year, respectively (SEERS database). In Brazil, epidemiologic data for CLL are very scarce. The aim of this study was to assess characteristics and to describe incidence rates (IR) for frontline and relapsed/refractory CLL treatment in the Brazilian public health system. A retrospective longitudinal analysis was performed based on Government administrative claims database (Datasus). Eligibility criteria were patients with CLL (ICD code C911) who received treatment from January-2011 to December-2014. IR were calculated by the ratio (number of CLL patients starting treatment)/(total population according to national statistics – IBGE and ANS), categorized by year and based on the following variables: gender, age group and 5 territorial regions. Parametric tests were used to compare different IR across the groups. 86,488 APACs (Authorization for High Complexity Procedures) met eligibility criteria, representing 8,633 patients. The population cohort (57.5% male) comprised patients with an average (±SD) age of 67.5±11.8yrs and 77% were 60yrs of age or over (30.7% 60-69yrs; 31.4% 70-79yrs). There was no statistically significant difference in global IR from 2011 to 2014 (average: 0.75/100,000 per year). Ages over 60yrs had the highest IR: 3.68/100,000 for 60-69yrs, 7.60/100,000 for 70-79yrs and 8.76/100,000 over 80yrs. The average of global IR was 1.38x higher for males (0.872/100,000) compared to females (0.632/100,000) (p<0.001). South region had the highest IR (1.19/100,000), followed by Southeast (0.94/100,000) and Center-west (0.61/100,000). Management of CLL patients is undergoing recent advances with the emergence of BTK inhibitors such as ibrutinib. Epidemiologic studies represent a powerful tool to better comprehend biology of disease and guide clinical decisions. This study showed characteristics of CLL treatment and indicated asymmetry in the Brazilian public healthcare system by age, gender, and geographical region.