{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T15:39:19Z","timestamp":1760369959959,"version":"build-2065373602"},"reference-count":34,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2023,11,26]],"date-time":"2023-11-26T00:00:00Z","timestamp":1700956800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: This monocentric retrospective study describes the treatment patterns and outcomes of chronic lymphocytic leukemia (CLL) patients. Methods: Adult CLL patients treated between 1992 and 2022 were included. The time to next treatment (TTNT) was defined as the time from the treatment\u2019s start to the start of a subsequent therapy or death. The time to next treatment failure or death (TTNTF) was defined as the time from treatment discontinuation to the discontinuation of a subsequent therapy or death. Results: Of 637 registered patients, 318 (49.9%) received treatment. We evaluated 157 cBTKi-exposed, 34 BCL2i-exposed cBTKi-na\u00efve, and 26 double-exposed patients. The five-year TTNT values in the cBTKi-exposed patients were 80% (median NR), 40% (median 40 months), and 21% (median 24 months) months in the first line (1L), second line (2L), and beyond the second line (&gt;2L), respectively (p &lt; 0.0001). The five-year TTNT values in the BCL2i-exposed patients were 83% (median NR), 72% (median NR), 12% (median 28 months) in the 1L, 2L, and &gt;2L, respectively (p = 0.185). The median TTNTF was 9 months (range 1\u201387) after cBTKi and 17 months (range 8\u201349) after both a cBTKi and BCL2i. Conclusions: This study suggests that, in CLL patients, the earlier we used targeted therapies, the better was the outcome obtained. Nonetheless, the poor outcomes in the advanced lines of therapy highlight the need for more effective treatments.<\/jats:p>","DOI":"10.3390\/cancers15235592","type":"journal-article","created":{"date-parts":[[2023,11,27]],"date-time":"2023-11-27T03:35:06Z","timestamp":1701056106000},"page":"5592","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Treatment Sequencing and Outcome of Chronic Lymphocytic Leukemia Patients Treated at Fondazione Policlinico Universitario Agostino Gemelli IRCCS: A Thirty-Year Single-Center Experience"],"prefix":"10.3390","volume":"15","author":[{"given":"Idanna","family":"Innocenti","sequence":"first","affiliation":[{"name":"Department of Diagnostic Imaging, Radiation Oncology and Hematology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8084-9009","authenticated-orcid":false,"given":"Alberto","family":"Fresa","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging, Radiation Oncology and Hematology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Section of Hematology, Department of Radiological and Hematological Sciences, Catholic University of Sacred Heart, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annamaria","family":"Tomasso","sequence":"additional","affiliation":[{"name":"Section of Hematology, Department of Radiological and Hematological Sciences, Catholic University of Sacred Heart, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michela","family":"Tarnani","sequence":"additional","affiliation":[{"name":"Hematology Department, Ospedale Belcolle, 01100 Viterbo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"De Padua","sequence":"additional","affiliation":[{"name":"Hematology Department, Fabrizio Spaziani Hospital, 03100 Frosinone, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulia","family":"Benintende","sequence":"additional","affiliation":[{"name":"Department of Medicine 5, Haematology and Oncology, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg (FAU), Universit\u00e4tsklinikum, 91054 Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2253-8883","authenticated-orcid":false,"given":"Raffaella","family":"Pasquale","sequence":"additional","affiliation":[{"name":"Azienda Sanitaria Universitaria Friuli Centrale (ASU FC), SOC Clinica Ematologia, 33100 Udine, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2839-916X","authenticated-orcid":false,"given":"Eugenio","family":"Galli","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging, Radiation Oncology and Hematology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Section of Hematology, Department of Radiological and Hematological Sciences, Catholic University of Sacred Heart, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5032-9192","authenticated-orcid":false,"given":"Francesca","family":"Morelli","sequence":"additional","affiliation":[{"name":"Department of Hematology, Universit\u00e1 degli Studi di Firenze, 50121 Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diana","family":"Giannarelli","sequence":"additional","affiliation":[{"name":"Facility of Epidemiology and Biostatistics, GSTeP, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7868-7469","authenticated-orcid":false,"given":"Francesco","family":"Autore","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging, Radiation Oncology and Hematology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8327-1396","authenticated-orcid":false,"given":"Luca","family":"Laurenti","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging, Radiation Oncology and Hematology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Section of Hematology, Department of Radiological and Hematological Sciences, Catholic University of Sacred Heart, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,26]]},"reference":[{"key":"ref_1","unstructured":"Howlader, N., Noone, A.M., Krapcho, M., Miller, D., Brest, A., Yu, M., Ruhl, J., Tatalovich, Z., Mariotto, A., and Lewis, D.R. 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