Tumor Lysis Syndrome Linked to Substantial Cost Burden in Patients With CLL/SLL

Patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) who developed tumor lysis syndrome had increased health care resource utilization and costs as well as a higher rate of treatment switching, according to a study published in the Journal of Managed Care & Specialty Pharmacy.

“A potentially fatal complication associated with some treatments used for CLL/SLL is tumor lysis syndrome,” researchers explained in the study background. “Tumor lysis syndrome occurs when tumor cells die and release large amounts of potassium, phosphorus, uric acid, and nucleic acids into the circulation, causing systemic damage.”

The real-world retrospective study looked at the clinical and economic burden of tumor lysis syndrome in 6343 patients with CLL/SLL in the United States initiated on a treatment regimen identified as having a high risk of developing the complication: chemotherapy, lenalidomide, obinutuzumab, or venetoclax.

According to the results, 1.1% of patients developed tumor lysis syndrome within 90 days of treatment. Rates of treatment-emergent tumor lysis syndrome were 11.5% with venetoclax and 0.8% with non-venetoclax regimens.

Patients with treatment-emergent tumor lysis syndrome had 1.7 times more inpatient admissions, 2 times more inpatient days, 22% fewer days of antineoplastic drug administration, and per-patient-per-month health care costs $3062 higher than patients who did not develop the condition. The increased costs were largely due to inpatient care, the study showed. Both venetoclax and non-venetoclax regimens were associated with increased costs.

Additionally, 12.6% of patients who developed tumor lysis syndrome switched treatment within in the first 90 days, compared with 5.1% of patients who did not develop tumor lysis syndrome.

“The risk of treatment-emergent tumor lysis syndrome and associated incremental health care resource utilization and costs, as well as the potential impact on quality of life, should be taken into consideration when evaluating the risk-benefit of therapies in CLL/SLL management,” researchers advised.

Janssen Scientific Affairs funded the study.

Reference:
Rogers KA, Lu X, Emond B, et al. Clinical and economic burden of tumor lysis syndrome among patients with chronic lymphocytic leukemia/small lymphocytic lymphoma: a real-world US retrospective study. J Manag Care Spec Pharm. 2022;28(9):1033-1045. doi:10.18553/jmcp.2022.22075