b'uFromPage 77did not receive or require treatment for chronic lym-phocytic leukemia were more likely to die from non-cancer causes compared to those who received treat-ment for chronic lymphocytic leukemia, who were more likely to die from a hematologic malignancy.Individually TailoredAll patients, both veteran and civilian, should be receivingfirstline,FDA-approvedtreatmentsfor chronic lymphocytic leukemia, tailored for each in-dividual patient, Ma recommended. TreatmentsforCLLincludedtargetedtherapies suchasBrutonstyrosinekinase(BTK)inhibitors, B-celllymphoma2(BCL-2)inhibitorsandphos-phoinositide-3kinase(PI3K)inhibitors,whichare increasingly used. Data suggested that patients who received BTK inhibitors in the first line or second line have a better survival compared to those receiv-A UH-1D helicopter from the 336th Aviation Company sprays a defoliation ing these targeted agents third line or later, the studyagent on a dense jungle area in the Mekong Delta. Photo from National authors advised.Archives ID 111-C-CC59950.Theimpactofthesetherapiesonoutcomesof chronic lymphocytic leukemia in U.S. military veter- In addition, many patients received targeted agents in ans, in whom lymphoid malignancies may be asso- subsequent lines of therapy. In patients who received ciated with unique epidemiological factors, has beenfirst-line chemoimmunotherapy (n = 2,568), about half unknown, the researchers noted. went on to receive additional therapy: chemoimmuno-Amongtreatedpatients,thestudyfoundthatthetherapy (n = 465, 18%), targeted therapies (n = 441, median time to first-line treatment was 1.9 years,17%), monoclonal antibody (n = 258, 10%) and che-andthemedianoverallsurvivalfrominitiationofmotherapy (n = 133, 5%), the authors explained.treatment was 5 years. The most common first-lineInpatientswhoreceivedchemotherapy(n= therapywaschemoimmunotherapy.However,first- 1,647), those who went on to second line chemoim-line treatment patterns varied over time. munotherapy were 22% (n = 369), chemotherapy The study reported that ibrutinib-based therapy was13% (n = 222), monoclonal antibody 11% (n = 180) the most common first-line targeted agent (n = 1,284,and targeted therapies 6% (n = 105). In those who 93%). That was followed by: received targeted treatment, subsequent therapiesVenetoclax-based therapy (n = 68, 5%),includedanothertargetedagent(n=155,11%),Acalabrutinib (n = 22, 2%),chemoimmunotherapy(n=32,2%),monoclonalCombinations of ibrutinib and venetoclax on aantibody (n = 27, 2%), and chemotherapy (n = 17, clinical trial (n = 4, 1%), and 1%), the authors pointed out. Idelalisib, which was given first line due toIn the 1,647 patients who received chemother-concern about giving ibrutinib with warfarin (napy, 22% went on to receive chemoimmunother-= 1, 1%). apy, including:Median overall survival from initiation of first-Chemotherapy,13% (n = 222), line therapy was 6.1 years for first-line chemoim-Monoclonal antibody 11% (n = 180), andmunotherapy, 5.5-plus years for targeted therapy, Targeted therapies 6% (n = 105).4.6 years for monoclonal antibody and 3.6 years forInthosewhoreceivedtargetedtreatment,subse-chemotherapy, according to the report.quenttherapiesincludedanothertargetedagent(n 78'