Chronic lymphocytic leukaemia in the Middle East: a subgroup analysis from the CREEK study on treatment patterns and outcomes

Background: This subgroup analysis investigates the clinical characteristics, treatment patterns, and outcomes of chronic lymphocytic leukemia (CLL) in the Middle East (ME). Research design and methods: Retrospective study retrieved medical records of CLL patients treated for ≥12 months (CLL-treated) or treatment-naïve (TN). Results included data from 442 CLL-treated and 123 TN patients across five ME countries. Results: CLL-treated group mean age: 61.1 ± 11.28 years; TN cohort: 63.5 ± 13.53 years. Most patients in both groups were male. CLL-IPI scores were mostly unavailable in both cohorts. Cytogenetic abnormalities were tested in 20.6% of CLL-treated and 18.7% of TN cohorts, with del(17p) being the most common abnormality (12.4% and 11.4%, respectively). TP53 aberrations were found in 9.0% of CLL-treated and 9.8% of TN cohorts. Regarding first-line treatment, 76.5% received CIT, while 17.9% received targeted therapies, with ibrutinib (75.9%) being the most common. CIT use led to significant resource utilization, including outpatient visits, length of stay, and blood transfusions. Conclusion: CLL management in the ME is characterized by suboptimal utilization of risk-based treatment and genetic testing despite access to targeted therapy. Poor CLL outcomes stem from reliance on CIT, associated with an unfavorable safety profile and healthcare resource use compared to targeted therapies in the region. Clinical trial registration: www.clinicaltrials.gov identifier is NCT04964908.