title: Altered treatment of chronic lymphocytic leukemia in Germany during the last decade.
abstract: Chronic lymphocytic leukemia (CLL) is the most common subtype of adult leukemia in the western world. We here report a nationwide survey monitoring the treatment decisions concerning CLL patients in Germany in 2011 and compare treatment trends to sequential surveys performed previously during the last decade. The rate of patients diagnosed in early stages (Binet A/B) notably increased (2006: 66 %, 2009: 71 %, 2011: 77 %) over the years. From 2006 to 2009, the most frequent applied regime switched from chlorambucil to fludarabine containing regimes (2006 chlorambucil: 32 %, 2009: 14 %, fludarabine 2006: 23 %, 2009: 37 %). In 2011, the combination of rituximab with bendamustine (31 %) was most frequent used followed by the rituximab-fludarabine-cyclophosphamide (22 %) regime. Further, immune-chemotherapies were administered significantly more often over the observation period (2006: 15 %, 2011: 73 %). Taken together, this data reflects the change of treatment strategies over the last decade in clinical reality.
authors.affiliation: Department of Internal Medicine III, University Hospital Munich-Großhadern, Marchioninistr. 15, 81377, Munich, Germany. anna.zoellner@med.lmu.de.
authors.forename: Anna-Katharina
authors.initials: AK
authors.lastname: Zoellner
authors.affiliation: Medizinische Klinik I - Hämatologie/Onkologie, Prosper-Hospital, Recklinghausen, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Höhler
authors.affiliation: Onkologischen Schwerpunktpraxis, Bamberg, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Fries
authors.affiliation: Onkologikum Frankfurt am Museumsufer, Frankfurt, Germany.
authors.forename: Angelika
authors.initials: A
authors.lastname: Böhme
authors.affiliation: Onkologische Praxis, Berlin, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Kiewe
authors.affiliation: Oncology Information Service, Freiburg, Germany.
authors.forename: Lenka
authors.initials: L
authors.lastname: Kellermann
authors.affiliation: Department of Internal Medicine III, University Hospital Munich-Großhadern, Marchioninistr. 15, 81377, Munich, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Dreyling
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D000069461:Bendamustine Hydrochloride / Q000008:administration & dosage; D002699:Chlorambucil / Q000008:administration & dosage; D005260:Female; D005858:Germany / Q000453:epidemiology; D019538:Health Care Surveys / Q000639:trends*; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D000069283:Rituximab / Q000008:administration & dosage; D016896:Treatment Outcome; D014740:Vidarabine / Q000008:administration & dosage / Q000031:analogs & derivatives
chemical_list: D002699:Chlorambucil; D000069283:Rituximab; D000069461:Bendamustine Hydrochloride; D014740:Vidarabine; C024352:fludarabine
keywords: CLL; Clinical practice; Rituximab-bendamustine; Rituximab-fludarabine-cyclophosphamide