Understanding Patient and Physician Perceptions Regarding Treatment-Related Adverse Events in First-Line Chronic Lymphocytic Leukemia (CLL)

• Published in: Blood 2023-11, Vol.142 (Supplement 1), p.6546-6546
• Main Authors: Sile, Bersabeh, Horchi, Dahbia, Rault, Bleuenn, Mulvihill, Emily, Beusterien, Kathleen, Stewart, Katherine, Palhares De Miranda, Paulo Andre P., Guillaume, Xavier
• Format: Article
• Language: English
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood-2023-177704

Background Chronic Lymphocytic Leukemia (CLL) patients have various treatment options which are all associated with different adverse events. A limited number of studies have explored how patients and physicians perceive these adverse events in the frontline treatment setting. Understanding the similarities and differences in perceptions between physicians and CLL patients is an important factor in supporting shared decision-making. Aims The objective of this multi-country study was to understand the differences in patients' and physicians' perception on treatment-related adverse events in CLL. Methods CLL patients and physicians managing CLL (oncologists, hematologist-oncologists, and hematologists) were invited to complete an online survey. Participants were recruited from the US, UK, Germany, France, and Australia. The survey included a best-worst scaling (BWS) exercise to assess how ‘bothersome’ 14 potential adverse events associated with 1L CLL treatments were perceived. In a series of 18 BWS choice tasks, participants chose which was most ‘bothersome’ and which was ‘least bothersome’ among subsets of 4 adverse events. A hierarchical Bayesian (HB) model was used to estimate BWS scores for each treatment-related adverse event: BWS scores sum to 100 for each participant and a higher score indicates that an adverse event is relatively more ‘bothersome’. Results The study included 192 patients and 259 physicians. The top four most bothersome adverse events were the same for both patients and physicians, however, these were ranked in a different order (Table 1). Physicians ranked the ‘risk of cardiac events/atrial fibrillation/flutter that may require medical treatment and/or hospitalization’ and ‘risk of bleeding (hemorrhage) that requires medical intervention and/or hospitalization’ as their 2 most bothersome adverse events while patients ranked ‘Risk of infection, such as pneumonia or blood infections (sepsis) requiring medical intervention and/or hospitalization’ and ‘Risk of tumor lysis syndrome (TLS) which requires hospitalization’ as their 2 most bothersome adverse events (Table 1). The 2 least bothersome adverse events for both physicians and patients were ‘Risk of mild-to-moderate muscle, joint or bone pain (mild-to-moderate pain not interfering with daily activities) that might go away with medication’ and ‘Risk of mild-to-moderate headache (not limiting daily activities or limiting only instrumental activities such as cooking, cleaning, transpor