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AML

(Acute Myeloid Leukemia)

Relevant Articles About Acute Myeloid Leukemia (AML)
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RELATED :ALL (Acute Lymphoblastic Leukemia):CLL (Chronic Lymphocytic Leukemia):CML (Chronic Myeloid Leukemia)

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AML (Acute Myeloid Leukemia)Other CancersATGBusulfanFludarabineMethotrexateProcedure: Stem Cell Product InfusionRadiation: Total Marrow IrradiationTacrolimusRecruitingUnited States 0NCT03121014Phase 2
Study of Intensity Modulated Total Marrow Irradiation (IM-TMI) in Addition to Fludarabine/Busulfan Conditioning for Allogeneic Transplantation in High Risk AML and Myelodysplastic Syndromes

Study of Intensity Modulated Total Marrow Irradiation (IM-TMI) in Addition to Fludarabine/Busulfan Conditioning for Allogeneic Transplantation in High Risk AML and Myelodysplastic Syndromes

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Effective PT in Largest IM Patient Series

KEY TAKEAWAYS The study aimed to report outcomes from a substantial series of IM treated with curative-intent proton therapy. The study's findings concluded proton therapy effectively treated IM with acceptable toxicity, representing a substantial patient cohort....

Jun 28, 2024

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Pirtobrutinib Shows Promise in BTKi Naïve CLL/SLL: BRUIN Study

KEY TAKEAWAYS

  • The BRUIN phase 1 & 2 trial aimed to investigate the efficacy and safety of pirtobrutinib as a 1L therapy in BTK inhibitor-naïve patients with CLL/SLL.
  • The key endpoints were to determine ORR, PFS & Safety.
  • Researchers noticed that Pirtobrutinib shows promising efficacy and tolerability.

Early lines of therapy for patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) often rely on targeted single-agent treatments like Bruton tyrosine kinase inhibitors (BTKi). Despite their efficacy, covalent BTKi have pharmacologic limitations such as low oral bioavailability and short half-life, potentially impacting BTK target coverage.

Pirtobrutinib, a non-covalent (reversible) BTKi, has shown promising efficacy and safety in relapsed or refractory (R/R) CLL/SLL, earning accelerated approval post multiple lines of therapy including BTKi and BCL2 inhibitors.

Dr. Toby Eyre and the team aimed to assess the efficacy and safety of pirtobrutinib as a first-line (1L) therapy in patients with BTKi-naïve CLL/SLL.

They performed an inclusive analysis of patients with R/R BTKi-naive CLL/SLL treated with pirtobrutinib. Key endpoints included overall response rate (ORR), assessed by both an independent review committee (IRC) and investigators per 2018 iwCLL criteria, progression-free survival (PFS), and safety outcomes.

About 35 patients with R/R BTKi-naïve CLL/SLL were treated with pirtobrutinib. The median age was 67 years (range, 38-81), with 18 patients (51.4%) male and 33 (94.3%) having an ECOG PS of 0-1. Patients had received a median of 2 prior therapies (range, 1-8) with 4 patients having only 1 prior therapy, 14 with 2 prior lines of therapy, and 17 with 3 or more prior lines of therapy. Predominantly including chemotherapy (100%), anti-CD20 antibody (97.1%), PI3K inhibitors (22.9%), and BCL-2 inhibitors (8.6%). Among those with available data, 20 out of 25 patients (80.0%) had unmutated IGHV, and 10 out of 27 (37.0%) had TP53 mutation and/or del(17p).

The median time on treatment was 28.8 months (mo), and the median time on study was 31.5 mo. The IRC-assessed ORR was 88.6% (95% CI, 73.3-96.8), with 1 patient (2.9%) achieving complete response (CR) and 30 (85.7%) partial responses (PR). The ORR including partial response with lymphocytosis (PR-L) was 91.4% (95% CI, 76.9-98.2), with 1 patient (2.9%) having PR-L. INV-assessed ORR was 85.7% (95%CI, 69.7-95.2), and including PR-L (n=3, 8.6%), was 94.3%(95%CI, 80.8-99.3).

The median follow-up was 28.1 months, and IRC-assessed median PFS was non-estimable (NE; 95% CI, 27.6-NE) with a 24-month PFS rate of 74.7% (95% CI, 55.7-86.5). INV-assessed median PFS was also NE (95%CI, 30.9-NE), and the 24-mo PFS rate was 81.8% (95%CI, 63.9-91.4). Common treatment-emergent adverse events (TEAE) included COVID-19 infection 19(n=16, 45.7%), neutropenia/neutrophil count decreased (n=15, 42.9%), and diarrhea (n=11, 31.4%).

Grade ≥3 TEAEs were predominantly infections ((n=16, 45.7%; n=9, 25.7% excluding COVID-19) and neutropenia/neutrophil count decreased (n=12, 34.3%). Grade ≥3 TEAEs of hypertension (8.6%, n=3), hemorrhage/hematoma (n=1, 2.9%), and a trial fibrillation/flutter (2.9%, n=1) were also observed. TEAEs led to pirtobrutinib dose reduction in 5 patients (14.3%) and discontinuation in 2 (5.7%). Two patients (5.7%) experienced fatal TEAEs due to COVID-19 infection, deemed unrelated to pirtobrutinib by investigators.

The study concluded that pirtobrutinib shows promising efficacy and good tolerability in patients with R/R BTKi-naïve CLL/SLL, with a low discontinuation rate. Ongoing phase 3 trials are assessing its use in patients with BTKi-naïve, including those in 1L treatment-naïve settings for CLL/SLL.

The trial was sponsored by Loxo Oncology, Inc.

Source: https://library.ehaweb.org/eha/2024/eha2024-congress/420720/toby.eyre.pirtobrutinib.in.relapsed.refractory.cll.sll.results.from.btki.nave.html?f=menu%3D6%2Abrowseby%3D8%2Asortby%3D2%2Ace_id%3D2552%2Aot_id%3D29194%2Amarker%3D5101%2Afeatured%3D18527

Clinical Trial: https://clinicaltrials.gov/study/NCT03740529

Eyre T, Marańda E L, Roeker L, et al. (2024). “PIRTOBRUTINIB IN RELAPSED/REFRACTORY CLL/SLL: RESULTS FROMBTKI NAÏVE COHORT IN THE PHASE 1/2 BRUIN STUDY.” Presented at EHA 2024.

Epcoritamab Shows Promise in RT: EPCORE CLL-1 Trial

KEY TAKEAWAYS

  • The EPCORE™ CLL-1 phase 1 & 2 trial aimed to investigate the efficacy and safety of epcoritamab in treating patients with RT.
  • Researchers observed promising efficacy and manageable safety of epcoritamab in RT.

RT is the transformation of chronic lymphocytic leukemia (CLL) into CD20+ diffuse large B-cell lymphoma (DLBCL), with poor prognosis exacerbated by prior CLL treatments and TP53 aberrations. Current chemoimmunotherapy (CIT) yields low complete response (CR) rates (≤20%). Epcoritamab, a subcutaneous CD3xCD20 bispecific antibody, is approved for relapsed or refractory large B-cell lymphoma. The ongoing EPCORE™ CLL​1 trial (NCT04623541) evaluates its safety and efficacy in RT. Preliminary results show promising efficacy and manageable safety.

Arnon P. Kater and the team aimed to assess the safety and efficacy of epcoritamab monotherapy in patients with Richter’s transformation (RT).

They performed an inclusive analysis of adults with biopsy-proven transformation to CD20+ DLBCL and a clinical history of CLL or small lymphocytic lymphoma. Patients with ≤2 prior lines of treatment for RT received epcoritamab 48 mg in 28-day cycles (QW, C1–3; Q2W, C4–9; Q4W, C≥10) until disease progression. To mitigate cytokine release syndrome (CRS), step-up dosing and corticosteroid prophylaxis were required in C1. Response was assessed using PET-CT per Lugano classification.

About 35 patients with RT had received epcoritamab as of October 5, 2023 (median follow-up of 8.1 months). A total of 91% of patients had ≥1 prior treatment line for CLL or RT, and 49% had prior treatment for RT. Most patients (57%) had received a Bruton’s tyrosine kinase or B-cell lymphoma 2 inhibitor prior to transformation, reflecting current treatment for CLL. The most common prior treatment for RT was an anti-CD20 monoclonal antibody-containing CIT regimen, primarily R-CHOP (in 76% of patients with prior treatment). As of data cutoff, 13 patients (37%) were still receiving epcoritamab.

In the response-evaluable population (n=26), the overall response rate (ORR) was 50%, and the complete response (CR) rate was 35%. Median times to response and CR were short (1.4 months and 2.4 months, respectively), and an estimated 53% of patients with CR remained in CR at 9 months (75% among patients with CR without prior treatment for RT). The most common nonhematologic treatment-emergent adverse event (TEAE) was cytokine release syndrome (CRS) (80%). Thrombocytopenia and anemia were observed in 40% of patients each at baseline and in 40% and 34% of patients, respectively, during the study per iwCLL criteria. CRS events primarily occurred following the first full dose, and most were low grade; only 1 patient (3%) had Grade 3 CRS.

Four patients had immune effector cell-associated neurotoxicity syndrome (ICANS) (Grade 1, n=2; Grade 2, n=2); all 4 patients had concurrent CRS. Clinical tumor lysis syndrome (CTLS) occurred in 3 patients (Grade 1–3, n=1 each). No CRS, ICANS, or CTLS events led to treatment discontinuation. Two patients discontinued treatment due to adverse events (AEs), and 3 patients had fatal TEAEs (general physical health deterioration [n=2] and sepsis). Data for all patients (N=42) from the fully enrolled cohort will be presented.

The study concluded that the first disclosure of data from a large RT cohort, now fully enrolled and with longer follow-up, demonstrates that epcoritamab treatment leads to encouraging ORR and CR rates in a high-risk population of patients with RT, with notably higher response rates in previously untreated RT. Safety was tolerable and consistent with prior reports; most CRS was low grade, and no new safety signals were observed.

Efforts to further mitigate CRS with C1 optimization, including an additional step-up dose of epcoritamab, are ongoing. These highly encouraging data support further evaluation of epcoritamab as a chemotherapy-free treatment option for patients with RT.

The trial was sponsored by the Genmab.

Source: https://library.ehaweb.org/eha/2024/eha2024-congress/422267/arnon.p.kater.single-agent.epcoritamab.leads.to.deep.responses.in.patients.html?f=menu%3D6%2Abrowseby%3D8%2Asortby%3D2%2Ace_id%3D2552%2Aot_id%3D29194%2Amarker%3D5099%2Afeatured%3D18527

Clinical Trial: https://clinicaltrials.gov/study/NCT04623541

Kater A.P., Janssens A, Eradat H, et al. (2024). “SINGLE-AGENT EPCORITAMAB LEADS TO DEEP RESPONSES IN PATIENTS(PTS) WITH RICHTER’S TRANSFORMATION (RT): PRIMARY RESULTS FROMTHE EPCORE CLL-1 TRIAL.” Presented at EHA 2024.

Real-World Acalabrutinib: High RW-PFS & Continuation Rates

KEY TAKEAWAYS

  • The EPIC trial aimed to present interim analysis of outcomes, patient characteristics, and treatment patterns in CLL post-acalabrutinib initiation.
  • The interim analysis reported real-world acalabrutinib outcomes aligning with ELEVATE-TN trial findings, informing UK clinical decisions.

High response rates and acceptable safety profiles were noted in clinical trials of acalabrutinib, a second-generation Bruton’s tyrosine kinase inhibitor, for patients with chronic lymphocytic leukemia (CLL). Nonetheless, there is a scarcity of UK real-world data regarding the utilization of first-line acalabrutinib in patients with CLL.

Nicolas Martinez-Calle and the team aimed to deliver an interim analysis of outcomes, clinical features, and treatment trends in patients with CLL following the initiation of first-line acalabrutinib via the UK Early Access Programme (EAP), with a minimum follow-up of 24 months.

This retrospective multi-center cohort study, registered under ClinicalTrials.gov (NCT05557695), focused on patients with CLL eligible if treatment-naïve and beginning acalabrutinib via the EAP between April 1, 2020, and April 1, 2021.

Patients, recruited from 16 sites in England and Wales, were assessed for real-world progression-free survival (rwPFS), real-world overall survival (rwOS), and real-world overall response rate (rwORR) during first-line treatment.

Data included baseline clinical and demographic characteristics as well as acalabrutinib treatment patterns, sourced from medical records. The study intends to track patients for up to 60 months post-acalabrutinib initiation (index date), with a data cut-off on November 30, 2023.

The results revealed that this interim analysis comprised 170 patients, with a median age at index of 74.5 years (IQR, 68.3–79.6). Among them, 41% were female, and the majority were White British. Most patients had an Eastern Cooperative Oncology Group performance score of 0-1.

The median Cumulative Illness Rating Scale-Geriatric score at index was 4. Acalabrutinib was primarily administered at a dose of 100 mg bi-daily. The median duration of follow-up was 36.9 months. rwPFS rate at 12 and 24 months was 92.4% (95% CI, 88.4 – 96.4) and 87.0% (95% CI, 82.1 – 92.2), respectively. The rwOS rate at 12 and 24 months was 92.9% (95% CI, 89.2–96.9) and 88.2% (95% CI, 83.5–93.2), respectively. The rwORR at 12 and 24 months was 87.0% (95% CI, 80.6–93.7; n=101) and 86.0% (95% CI, 79.9–92.0; n=128), respectively.

At index, a notable proportion of patients had creatinine clearance <60 mL/min and various mutations were observed. The median time from CLL diagnosis to index was 3.2 years. A significant portion of patients had comorbidities such as hypertension, type-2 diabetes, kidney disease, and atrial fibrillation.

Treatment continuation rates at 12 and 24 months were 87.6% (95% CI, 82.7–92.7, n=169) and 79.3% (95% CI,73.4–85.6, n=169), respectively. At data cut-off, 24% (40/169) patients had discontinued acalabrutinib (1 had no record); 38% (15/40) of discontinuations were due to adverse events, 13% (5/40) disease progression, 5% (2/40) patients’ decision and 43% (17/40) other (1 patient had no reason recorded); most common adverse events leading to discontinuations (≥1 AE could be reported per discontinuation) included cardiovascular, haematoma, and Richter transformation (n=2 each).

The study concluded that real-world acalabrutinib outcomes, including a 24-month rwPFS rate of 87.0% and a treatment continuation rate of 79.3%, align with findings from the ELEVATE-TN trial (NCT02475681). These results offer valuable insights for clinical decision-makers regarding the utilization of acalabrutinib in UK settings.

The trial was sponsored by AstraZeneca.

Source: https://library.ehaweb.org/eha/2024/eha2024-congress/419920/nicolas.martinez-calle.outcomes.of.epic.a.non-interventional.observational.html?f=menu%3D6%2Abrowseby%3D8%2Asortby%3D2%2Ace_id%3D2552%2Aot_id%3D29194%2Amarker%3D5100%2Afeatured%3D18527

Clinical Trial: https://clinicaltrials.gov/study/NCT05557695

Martinez-Calle N, Walewska R, Paneesha S, et al. (2024). “OUTCOMES OF EPIC: A NON-INTERVENTIONAL, OBSERVATIONAL STUDY OF PATIENTS WITH CHRONIC LYMPHOCYTIC LEUKAEMIA TREATED WITH FIRST-LINE ACALABRUTINIB VIA THE UK EARLY ACCESS PROGRAMME; INTERIM ANALYSES.” Presented at EHA 2024 (P1833).

Efficient MRD Assessment with Dr. PCR in CML

Efficient MRD Assessment with Dr. PCR in CML

KEY TAKEAWAYS

  • The study aimed to assess Dr. PCR’s accuracy in quantifying BCR::ABL1 transcripts for MRD monitoring in patients with CML.
  • Researchers concluded that Dr. PCR offers rapid and efficient MRD assessment.

Accurate quantification of the BCR::ABL1 transcripts is crucial for measurable residual disease (MRD) monitoring in chronic myeloid leukemia (CML) following tyrosine kinase inhibitor (TKI) treatment.

Soo Jung Lee and the team aimed to evaluate the newly developed digital real-time PCR method, Dr. PCR, as an alternative to reverse transcription-PCR (qRT-PCR) for MRD detection.

They conducted a comprehensive analysis, evaluating Dr. PCR’s performance using both reference and clinical materials. They assessed precision, linearity, and correlation with qRT-PCR. They compared MRD levels detected by Dr. PCR with qRT-PCR and investigated practical advantages.

Dr. PCR detected MRD up to 0.0032%IS (MR4.5) with excellent precision and linearity and showed a strong correlation with qRT-PCR results. Notably, Dr. PCR identified higher levels of MRD in 12.7% (29/229) of patients than qRT-PCR, including 6 cases of MR4, which is a critical level for TKI discontinuation. Dr. PCR also allowed for sufficient ABL1 copies in all cases, while qRT-PCR necessitated multiple repeat tests in 3.5% (8/229) of cases.

The study concluded that Dr. PCR offers a rapid and efficient method for assessing MRD in patients with CML under the current treatment regimen, supported by a robust body of evidence.

This study was supported by The Catholic University of Korea.

Source: https://pubmed.ncbi.nlm.nih.gov/38525919/

Lee SJ, Lee JM, Ahn A, et al.(2024). “Analytical Performance Evaluation of a Digital Real-Time PCR for Quantifying Major BCR::ABL1 Transcripts.” J Clin Lab Anal. 2024 Apr;38(7):e25034. doi: 10.1002/jcla.25034. Epub 2024 Mar 25. PMID: 38525919; PMCID: PMC11033343.

Cancer Cell Cycle Control: Integrating Gene Regulation and Therapy

KEY TAKEAWAYS

  • The study aimed to understand how drug effects relate to cancer cell diversity to find effective combination therapies.
  • The results revealed insights into gene regulation and support sequential WEE1 and low-toxicity pre-BCR inhibitor therapy.

Targeted therapies that exploit cancer cell vulnerabilities show promise for improving patient outcomes and reducing chemotherapy side effects. However, the efficacy of precision therapies is partly limited by tumor cell heterogeneity. Understanding how drug effects are linked to the diversity of cancer cell states is crucial for identifying effective combination therapies to prevent disease recurrence.

Alena Malyukova and the team aimed to understand how G2/M checkpoint inhibition affects cell fate in acute lymphoblastic leukemia (ALL) to improve combination therapies.

Researchers characterized the effect of G2/M checkpoint inhibition in ALL, demonstrating that WEE1 targeted therapy affects cell fate decision regulatory circuits. They observed the highest inhibition of proliferation recovery in ALL cells with KMT2A rearrangements. Using single-cell RNA-seq and ATAC-seq on RS4, 11 cells harboring KMT2A::AFF1 were treated with the WEE1 inhibitor AZD1775, and they found a diversification of cell states.

A fraction of cells showed strong activation of p53-driven processes linked to apoptosis and senescence and disruption of a core KMT2A-RUNX1-MYC regulatory network. In this WEE1 inhibition-induced cell state diversification, some cells transitioned to a drug-tolerant state, characterized by activation of transcription factors regulating pre-B cell fate, lipid metabolism, and pre-BCR signaling in a reversible manner. Sequential treatment with BCR-signaling inhibitors dasatinib or ibrutinib, or metabolism perturbation by fatostatin or AZD2014, effectively countered drug tolerance by inducing cell death and repressing stemness markers.

The study concluded that gene regulatory programs associated with cell cycle and cell fate regulation are tightly connected. It provides a rationale for the sequential administration of WEE1 inhibitors with low-toxicity inhibitors of pre-BCR signaling or metabolism.

No funding information was available.

Source: https://pubmed.ncbi.nlm.nih.gov/38822412/

Malyukova A, Lahnalampi M, Falqués-Costa T, et al. (2024). “Sequential drug treatment targeting cell cycle and cell fate regulatory programs blocks non-genetic cancer evolution in acute lymphoblastic leukemia.” Genome Biol. 2024 May 31;25(1):143. doi: 10.1186/s13059-024-03260-4. PMID: 38822412; PMCID: PMC11143599.

Ibrutinib Induces Atrial Arrhythmia via PI3K Pathway

KEY TAKEAWAYS

  • The study aimed to understand the precise mechanism behind ibrutinib-induced atrial fibrillation in patients with CLL.
  • The results revealed that the ibrutinib’s off-target effect on PI3K-AKT-mTOR causes connexin degradation, promoting autophagy and atrial arrhythmia.

Ibrutinib has been associated with an increased risk of atrial fibrillation (AF) in patients with chronic lymphocytic leukemia (CLL). However, the precise mechanism behind this effect is not yet fully understood.

Huiyuan Qin and the team aimed to determine the incidence of new-onset atrial fibrillation (AF) in patients with CLL receiving ibrutinib and elucidate its underlying mechanism.

Researchers investigated the prevalence of new-onset AF in patients with CLL undergoing treatment with ibrutinib. They utilized optical mapping to elucidate the proarrhythmic effects of ibrutinib on HL-1 cells.

Furthermore, fluorescence staining and western blot analysis were employed to compare the expression levels of connexins 43 and 40 between the ibrutinib-treated group and the control group. To characterize autophagy phenotypes, they utilized western blotting to assess the levels of autophagy-related proteins.

The study employed transmission electron microscopy (TEM) to visualize autophagosomes and used a transfected mCherry-GFP-LC3 virus to label autophagosomes and lysosomes. Additionally, hydroxychloroquine, an autophagy inhibitor, was administered to counteract ibrutinib-induced degradation of Cx43 and Cx40.

About 2.67% of patients experienced atrial arrhythmias following the administration of ibrutinib. HL-1 cells subjected to ibrutinib treatment displayed decreased conduction velocity and a heightened occurrence of reentry-like arrhythmias compared to the control group.

Furthermore, the expression of connexins 43 and 40 was reduced, accompanied by an increase in autophagy markers in HL-1 cells treated with ibrutinib. The inhibition of autophagy led to the upregulation of connexins 43 and 40.

The off-target impact of ibrutinib on the PI3K-AKT-mTOR signaling pathway resulted in the degradation of connexins and the onset of atrial arrhythmia by inducing autophagy.

Funding was provided by the National Nature Science Foundation of China.

Source: https://pubmed.ncbi.nlm.nih.gov/38812314/

Qin H, Zheng B, Lin Z, et al. (2024). “Ibrutinib Contributes to Atrial Arrhythmia through the Autophagic Degradation of Connexins by Inhibiting the PI3K-AKT-mTOR Signaling Pathway.” Front Biosci (Landmark Ed). 2024 May 22;29(5):201. doi: 10.31083/j.fbl2905201. PMID: 38812314.

Real-World CLL/SLL Treatment Trends and Healthcare Costs

KEY TAKEAWAYS

  • The study aimed to investigate the real-world treatment patterns, healthcare resource utilization, and economic burden of patients with CLL or SLL in the US.
  • Researchers noticed a significant shift in targeted therapies in CLL treatment and the significant economic burden on patients with CLL/SLL.

Chronic lymphocytic leukemia (CLL) is the most common type of leukemia among US adults and has experienced a rapidly evolving treatment landscape. Yet, current data on treatment patterns in clinical practice and economic burden are limited.

Xiaoqin Yang and the team aimed to provide an up-to-date description of real-world characteristics, treatments, and costs of patients with CLL or small lymphocytic lymphoma (SLL).

They performed an inclusive analysis utilizing retrospective data from the Optum Clinformatics DataMart database (January 2013 to December 2021). Adults with diagnosis codes for CLL/SLL on two different dates were selected, and an adapted algorithm identified lines of therapy (LOT). Treatment patterns were stratified by the index year pre- and post-2018. Healthcare resource utilization and costs were evaluated per patient-years.

About 18,418 patients with CLL/SLL were identified. Of these, 5,226 patients (28%) received treatment with at least 1 line of therapy (LOT), while 1,728 patients (9%) received treatment with at least two LOT. Among patients diagnosed with CLL between 2014 and 2017 and receiving at least one LOT (N = 2,585), 42% utilized targeted therapy, and 30% utilized chemoimmunotherapy in the first line (1L).

In contrast, among patients diagnosed with CLL between 2018 and 2021 (N = 2,641), these proportions rose to 54% and 16%, respectively. Total costs were approximately 3.5 times higher and 4.9 times higher compared to baseline costs among patients treated with 1L+ and 3L+, respectively.

The study concluded that there has been a notable real-world change in the CLL treatment landscape, with targeted therapies being increasingly utilized as first-line treatments, comprising more than half of first-line regimens in recent years (2018-2021). Additionally, the study highlighted the substantial economic burden faced by patients with CLL/SLL.

This study was funded by Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA.

Source: https://pubmed.ncbi.nlm.nih.gov/38280190/

Yang X, Zanardo E, Lejeune D, et al. (2024). “Treatment Patterns, Healthcare Resource Utilization, and Costs of Patients With Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma in the US.” Oncologist. 2024 Mar 4;29(3):e360-e371. doi: 10.1093/oncolo/oyad324. PMID: 38280190; PMCID: PMC10911928.

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