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Background: Chronic lymphocytic leukemia (CLL) is the most common leukemia in adults, including elderly veterans, with many new treatment options now available. Data on patterns of treatment in elderly veteran patients with CLL is limited. We sought to assess initial treatment patterns over a 13-year period among veteran patients in the Minneapolis VA Health Care System.

Methods: We identified 6,756 CLL cases diagnosed from 2000 to 2013 and are presenting interim data on 2015. We reviewed clinical data from 2,015 patients with CLL diagnosed from 2000 to 2013 and identified through the National VA Tumor Registry. Baseline demographics and treatment information were collected. The objective of this study was to assess initial treatment patterns, time to initial treatment, and variation of these parameters by age.

Results: At diagnosis, median age was 69 years (range, 37-96 years); 98% were male (1,979); Rai stage was 0 (n = 1,331, 66%), 1 (n = 317, 16%), 2 (n = 156, 8%), 3 (n = 91, 5%), 4 (n = 113, 6%). The majority of patients were white (n = 1,752, 87%); followed by African American (n = 203, 10%); and Hispanic (n = 33, 2%). Of the 2,015 patients, 751 (37%) received therapy over this period of follow-up. Median time from diagnosis to initial treatment was 1.3 years (range, 0-13 years). The most common initial therapies utilized were chlorambucil (39.4%); fludarabine/cyclophosphamide/ritux-imab (FCR) (12.4%); and single-agent fludarabine (10.5%). When examining these parameters by age in decades, we found that there were no differences in Rai stage at diagnosis by age-decade. There was a progressive increase in initial chlorambucil usage by advancing age. Likewise, the majority of FCR usage was in patients aged < 70 years.

Conclusions: In this veteran population, including many elderly patients, the majority of patients requiring therapy initiated it within 2 years of diagnosis. These patients were most commonly treated with chlorambucil. These patterns of care will be changing with the introduction of newer oral agents, such as ibrutinib and idelalisib, but at a significantly higher cost. The National VA Tumor Registry data will allow future opportunity to examine evolving treatment patterns in both an elderly as well as a veteran population. Updated data will be presented at the AVAHO annual meeting.

Background: Chronic lymphocytic leukemia (CLL) is the most common leukemia in adults, including elderly veterans, with many new treatment options now available. Data on patterns of treatment in elderly veteran patients with CLL is limited. We sought to assess initial treatment patterns over a 13-year period among veteran patients in the Minneapolis VA Health Care System.

Methods: We identified 6,756 CLL cases diagnosed from 2000 to 2013 and are presenting interim data on 2015. We reviewed clinical data from 2,015 patients with CLL diagnosed from 2000 to 2013 and identified through the National VA Tumor Registry. Baseline demographics and treatment information were collected. The objective of this study was to assess initial treatment patterns, time to initial treatment, and variation of these parameters by age.

Results: At diagnosis, median age was 69 years (range, 37-96 years); 98% were male (1,979); Rai stage was 0 (n = 1,331, 66%), 1 (n = 317, 16%), 2 (n = 156, 8%), 3 (n = 91, 5%), 4 (n = 113, 6%). The majority of patients were white (n = 1,752, 87%); followed by African American (n = 203, 10%); and Hispanic (n = 33, 2%). Of the 2,015 patients, 751 (37%) received therapy over this period of follow-up. Median time from diagnosis to initial treatment was 1.3 years (range, 0-13 years). The most common initial therapies utilized were chlorambucil (39.4%); fludarabine/cyclophosphamide/ritux-imab (FCR) (12.4%); and single-agent fludarabine (10.5%). When examining these parameters by age in decades, we found that there were no differences in Rai stage at diagnosis by age-decade. There was a progressive increase in initial chlorambucil usage by advancing age. Likewise, the majority of FCR usage was in patients aged < 70 years.

Conclusions: In this veteran population, including many elderly patients, the majority of patients requiring therapy initiated it within 2 years of diagnosis. These patients were most commonly treated with chlorambucil. These patterns of care will be changing with the introduction of newer oral agents, such as ibrutinib and idelalisib, but at a significantly higher cost. The National VA Tumor Registry data will allow future opportunity to examine evolving treatment patterns in both an elderly as well as a veteran population. Updated data will be presented at the AVAHO annual meeting.

Background: Chronic lymphocytic leukemia (CLL) is the most common leukemia in adults, including elderly veterans, with many new treatment options now available. Data on patterns of treatment in elderly veteran patients with CLL is limited. We sought to assess initial treatment patterns over a 13-year period among veteran patients in the Minneapolis VA Health Care System.

Methods: We identified 6,756 CLL cases diagnosed from 2000 to 2013 and are presenting interim data on 2015. We reviewed clinical data from 2,015 patients with CLL diagnosed from 2000 to 2013 and identified through the National VA Tumor Registry. Baseline demographics and treatment information were collected. The objective of this study was to assess initial treatment patterns, time to initial treatment, and variation of these parameters by age.

Results: At diagnosis, median age was 69 years (range, 37-96 years); 98% were male (1,979); Rai stage was 0 (n = 1,331, 66%), 1 (n = 317, 16%), 2 (n = 156, 8%), 3 (n = 91, 5%), 4 (n = 113, 6%). The majority of patients were white (n = 1,752, 87%); followed by African American (n = 203, 10%); and Hispanic (n = 33, 2%). Of the 2,015 patients, 751 (37%) received therapy over this period of follow-up. Median time from diagnosis to initial treatment was 1.3 years (range, 0-13 years). The most common initial therapies utilized were chlorambucil (39.4%); fludarabine/cyclophosphamide/ritux-imab (FCR) (12.4%); and single-agent fludarabine (10.5%). When examining these parameters by age in decades, we found that there were no differences in Rai stage at diagnosis by age-decade. There was a progressive increase in initial chlorambucil usage by advancing age. Likewise, the majority of FCR usage was in patients aged < 70 years.

Conclusions: In this veteran population, including many elderly patients, the majority of patients requiring therapy initiated it within 2 years of diagnosis. These patients were most commonly treated with chlorambucil. These patterns of care will be changing with the introduction of newer oral agents, such as ibrutinib and idelalisib, but at a significantly higher cost. The National VA Tumor Registry data will allow future opportunity to examine evolving treatment patterns in both an elderly as well as a veteran population. Updated data will be presented at the AVAHO annual meeting.

Background: Chronic lymphocytic leukemia (CLL) is the most common leukemia in adults, including elderly veterans. Some veterans have a history of Agent Orange exposure, which may potentially impact their presentation and disease course. We sought to assess initial patterns of cytogenetic aberrations among patients with CLL within the Minneapolis VA Health Care System (MVAHCS).

Methods: For this interim analysis, we evaluated a subset (30%) of a larger sample (6,756). We reviewed clinical data from 2,015 patients with CLL diagnosed from 2000 to 2013 and identified through the National VA Tumor Registry. Baseline demographics, including bone marrow/cytogenetic findings and treatment information were collected. The objective of this study was to assess initial cytogenetic patterns and variation of these parameters by age and Agent Orange exposure.

Results: Median age at diagnosis was 69 years (range, 37-96 years); 98% were male (1,979); Rai stage was 0 (n = 1,331, 66%), 1 (n = 317, 16%), 2 (n = 156, 8%), 3 (n = 91, 5%), 4 (n = 113, 6%). Cytogenetic data were available on 590 of 2,015 (29%) patients. Cytogenetic findings were normal in 258 (44%) patients. Abnormal cytogenetic findings in the remaining 330 cases included del 13q (28%); trisomy 12 (15%); del 11q (11%); del 17p (6%); and other abnor-malities (13%). Of 330 patients with noted abnormalities, 191 (58%) had 1 abnormality; 60 (18%) had 2; and 79 (24%) had > 2 abnormalities. Out of 2,015 patients, 283 (14%) had a reported exposure to Agent Orange; cytogenetic information was available in 130 (46%). Chromosomal abnormalities were detected in 80 of 130 cases (62%). The most frequent abnormality was del 13q (40%); trisomy 12 (19%); other abnormalities (18%); and del 11q (17%). Of the 80 pa-tients with noted abnormalities, 44 (55%) had 1 abnormality;14 (18%) had 2; and 22 (28%) had > 2 abnormalities.

Conclusions: Cytogenetic abnormalities in CLL play an important role in predicting disease progression and survival. These abnormalities paired with Agent Orange exposure have yet to be explored. Utilization of the National VA Tumor Registry data will allow the opportunity to examine the impact, if any, of Agent Orange exposure on the presentation and disease course of veterans with CLL. Updated cytogenetic findings will be presented at the AVAHO annual meeting.

Background: Chronic lymphocytic leukemia (CLL) is the most common leukemia in adults, including elderly veterans. Some veterans have a history of Agent Orange exposure, which may potentially impact their presentation and disease course. We sought to assess initial patterns of cytogenetic aberrations among patients with CLL within the Minneapolis VA Health Care System (MVAHCS).

Methods: For this interim analysis, we evaluated a subset (30%) of a larger sample (6,756). We reviewed clinical data from 2,015 patients with CLL diagnosed from 2000 to 2013 and identified through the National VA Tumor Registry. Baseline demographics, including bone marrow/cytogenetic findings and treatment information were collected. The objective of this study was to assess initial cytogenetic patterns and variation of these parameters by age and Agent Orange exposure.

Results: Median age at diagnosis was 69 years (range, 37-96 years); 98% were male (1,979); Rai stage was 0 (n = 1,331, 66%), 1 (n = 317, 16%), 2 (n = 156, 8%), 3 (n = 91, 5%), 4 (n = 113, 6%). Cytogenetic data were available on 590 of 2,015 (29%) patients. Cytogenetic findings were normal in 258 (44%) patients. Abnormal cytogenetic findings in the remaining 330 cases included del 13q (28%); trisomy 12 (15%); del 11q (11%); del 17p (6%); and other abnor-malities (13%). Of 330 patients with noted abnormalities, 191 (58%) had 1 abnormality; 60 (18%) had 2; and 79 (24%) had > 2 abnormalities. Out of 2,015 patients, 283 (14%) had a reported exposure to Agent Orange; cytogenetic information was available in 130 (46%). Chromosomal abnormalities were detected in 80 of 130 cases (62%). The most frequent abnormality was del 13q (40%); trisomy 12 (19%); other abnormalities (18%); and del 11q (17%). Of the 80 pa-tients with noted abnormalities, 44 (55%) had 1 abnormality;14 (18%) had 2; and 22 (28%) had > 2 abnormalities.

Conclusions: Cytogenetic abnormalities in CLL play an important role in predicting disease progression and survival. These abnormalities paired with Agent Orange exposure have yet to be explored. Utilization of the National VA Tumor Registry data will allow the opportunity to examine the impact, if any, of Agent Orange exposure on the presentation and disease course of veterans with CLL. Updated cytogenetic findings will be presented at the AVAHO annual meeting.

Background: Chronic lymphocytic leukemia (CLL) is the most common leukemia in adults, including elderly veterans. Some veterans have a history of Agent Orange exposure, which may potentially impact their presentation and disease course. We sought to assess initial patterns of cytogenetic aberrations among patients with CLL within the Minneapolis VA Health Care System (MVAHCS).

Methods: For this interim analysis, we evaluated a subset (30%) of a larger sample (6,756). We reviewed clinical data from 2,015 patients with CLL diagnosed from 2000 to 2013 and identified through the National VA Tumor Registry. Baseline demographics, including bone marrow/cytogenetic findings and treatment information were collected. The objective of this study was to assess initial cytogenetic patterns and variation of these parameters by age and Agent Orange exposure.

Results: Median age at diagnosis was 69 years (range, 37-96 years); 98% were male (1,979); Rai stage was 0 (n = 1,331, 66%), 1 (n = 317, 16%), 2 (n = 156, 8%), 3 (n = 91, 5%), 4 (n = 113, 6%). Cytogenetic data were available on 590 of 2,015 (29%) patients. Cytogenetic findings were normal in 258 (44%) patients. Abnormal cytogenetic findings in the remaining 330 cases included del 13q (28%); trisomy 12 (15%); del 11q (11%); del 17p (6%); and other abnor-malities (13%). Of 330 patients with noted abnormalities, 191 (58%) had 1 abnormality; 60 (18%) had 2; and 79 (24%) had > 2 abnormalities. Out of 2,015 patients, 283 (14%) had a reported exposure to Agent Orange; cytogenetic information was available in 130 (46%). Chromosomal abnormalities were detected in 80 of 130 cases (62%). The most frequent abnormality was del 13q (40%); trisomy 12 (19%); other abnormalities (18%); and del 11q (17%). Of the 80 pa-tients with noted abnormalities, 44 (55%) had 1 abnormality;14 (18%) had 2; and 22 (28%) had > 2 abnormalities.

Conclusions: Cytogenetic abnormalities in CLL play an important role in predicting disease progression and survival. These abnormalities paired with Agent Orange exposure have yet to be explored. Utilization of the National VA Tumor Registry data will allow the opportunity to examine the impact, if any, of Agent Orange exposure on the presentation and disease course of veterans with CLL. Updated cytogenetic findings will be presented at the AVAHO annual meeting.