Real-World Evidence on the Clinical Characteristics and Management of Patients with Chronic Lymphocytic Leukemia in Spain Using Natural Language Processing: The SRealCLL Study

Autores de IIS La Fe

• Antonio Gutierrez Laso

  Autor

Participantes ajenos a IIS La Fe

• Loscertales, Javier
• Abrisqueta-Costa, Pau
• Hernandez-Rivas, Jose Angel
• Andreu-Lapiedra, Rafael
• Mora, Alba
• Leiva-Farre, Carolina
• Lopez-Roda, Maria Dolores
• Callejo-Mellen, Angel
• Alvarez-Garcia, Esther
• Garcia-Marco, Jose Antonio

Abstract

The SRealCLL study aimed to obtain real-world evidence on the clinical characteristics and treatment patterns of patients with chronic lymphocytic leukemia (CLL) using natural language processing (NLP). Electronic health records (EHRs) from seven Spanish hospitals (January 2016-December 2018) were analyzed using EHRead (R) technology, based on NLP and machine learning. A total of 534 CLL patients were assessed. No treatment was detected in 270 (50.6%) patients (watch-and-wait, W & W). First-line (1L) treatment was identified in 230 (43.1%) patients and relapsed/refractory (2L) treatment was identified in 58 (10.9%). The median age ranged from 71 to 75 years, with a uniform male predominance (54.8-63.8%). The main comorbidities included hypertension (W & W: 35.6%; 1L: 38.3%; 2L: 39.7%), diabetes mellitus (W & W: 24.4%; 1L: 24.3%; 2L: 31%), cardiac arrhythmia (W & W: 16.7%; 1L: 17.8%; 2L: 17.2%), heart failure (W & W 16.3%, 1L 17.4%, 2L 17.2%), and dyslipidemia (W & W: 13.7%; 1L: 18.7%; 2L: 19.0%). The most common antineoplastic treatment was ibrutinib in 1L (64.8%) and 2L (62.1%), followed by bendamustine + rituximab (12.6%), obinutuzumab + chlorambucil (5.2%), rituximab + chlorambucil (4.8%), and idelalisib + rituximab (3.9%) in 1L and venetoclax (15.5%), idelalisib + rituximab (6.9%), bendamustine + rituximab (3.5%), and venetoclax + rituximab (3.5%) in 2L. This study expands the information available on patients with CLL in Spain, describing the diversity in patient characteristics and therapeutic approaches in clinical practice.

Keywords

• artificial intelligence; chronic lymphocytic leukemia; electronic health records; natural language processing; real-world evidence