TP4 A RETROSPECTIVE MEDICAL CLAIMS ANALYSIS OF ACUTE LYMPHOBLASTIC LEUKEMA TREATMENT TRENDS AMONG ADOLESCENTS AND YOUNG ADULTS

Abstract

Clinical studies have demonstrated that adolescents and young adults (AYAs) diagnosed with acute lymphoblastic leukemia (ALL) have better survival outcomes when treated with pediatric-inspired ALL regimens. The purpose of this retrospective analysis was to examine the trends in use of pediatric-inspired ALL regimens over time among AYA ALL patients. Newly diagnosed ALL patients within the IQVIA medical claims database (representing 3.2 million oncology patients in the US) were retrospectively identified by diagnosis code C91.00. Patients aged 18 to 39 were included and assigned to time cohorts based on date of new ALL diagnosis, and were designated as having received treatment with regimens consisting of chemotherapy only (e.g. HYPER-CVAD), or with pediatric-inspired ALL regimens containing chemotherapy and asparaginase. The study period was from July 2016 to June 2019. 1,476 patients were included. Median patient age of 25 years (min=18, max=39), 64% male and 36% female, 4% Medicaid. Patient sample was geographically representative of the four US census regions. Median patient follow-up from diagnosis was 14.1 months. Over the course of the study period, the minimum and maximum percentages of patients receiving pediatric-inspired ALL regimens were 33% and 41%, respectively with 33% in the second half of 2016 (beginning of study period) and 35% in the first half of 2019 (end of study period). The likelihood ratio test from a generalized linear regression model with time as a categorical predictor indicated that the percentage of patients receiving pediatric-inspired regimens did not change significantly over time (p=0.48). In this retrospective medical claims analysis, the percentage of AYA ALL patients receiving pediatric-inspired ALL regimens did not substantially improve since 2016, despite substantial clinical evidence supporting their use. These findings suggest there is a need for continued education on pediatric-inspired ALL regimens in AYA ALL populations to help improve patient survival outcomes.