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Master Thesis

Évaluation des pratiques cliniques françaises dans la leucémie lymphoïde chronique (LLC) en première rechute après immunochimiothérapie

Abstract : Introduction: actual strategy for treatment of chronic lymphocytic leukemia (CLL) in first relapse after immunochemotherapy (ICT) is based on Ibrutinib or the combination Rituximab (R) – Venetoclax. Methods: we aimed to evaluate French national practices in this situation with on-line questionnaire consisting of 6 vignettes of patients in this situation. The treatment choice and the associated justifications were collected, also characteristics of answering physicians allowing to estimate 3 levels of expertise. Results: we collected answers from 139 physicians, with a total of 795 answers. Ibrutinib was the most frequently prescribed treatment, in 58% of cases versus 33% for R-Venetoclax. The mainly associated justifications to Ibrutinib were cytogenetic characteristics (46%), patient’s tolerance profile (45%), clinical presentation of the disease (36%), prescription logistics (36%) and prescribing habits (28%). The mainly associated justifications to R-Venetoclax were duration of treatment (70%), tolerance profile (51%), cytogenetic characteristics (33%), clinical presentation of the disease (30%). ICT was prescribed in 7% of cases. Physicians with a high expertise level prescribed more frequently R-Venetoclax (52%) than those with intermediary (28%) or low expertise level (27%). Multiple correspondence analysis found a cluster of physicians who essentially prescribed R-Venetoclax, had participated in a CLL board and included patients in a clinical trial recently, had been a CLL clinical trial investigator and were members of coordinating group FILO. Conclusion: ibrutinib was the preferred treatment in most cases, but R- Venetoclax was the main prescription for physicians with the higher expertise level.
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https://dumas.ccsd.cnrs.fr/dumas-02957566
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Submitted on : Monday, October 5, 2020 - 11:45:29 AM
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Nathan Mottal. Évaluation des pratiques cliniques françaises dans la leucémie lymphoïde chronique (LLC) en première rechute après immunochimiothérapie. Sciences du Vivant [q-bio]. 2020. ⟨dumas-02957566⟩

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