P107 | CHRONIC LYMPHOCYTIC LEUKEMIA (CLL) IN THE REAL WORD :THE CAMPANIA EXPERIENCE WITH FIRST –LINE IBRUTINIB AND VENETOCLAX

Introduction The therapeutic landscape of CLL has undergone a deep transformation in the last decade. The most significant advance has been the introduction of V and I in the first line, thanks to the demonstration of their efficacy both as monotherapy and in combination, even in high-risk patients (pts) Aims To provide a descriptive overview on I+V treatment in CLL pts evaluated from the CLL Campania Group. Pts – Methods From March 2024 to April 2025, 49 pts were enrolled and characteristics are summarized in Table 1. Fitness was avaluated by considering age (>65 ) and comorbidity. Treatment was started according to current guidelines and therapy was administered at standard dose and schedule. G-CSF prophylaxis was done with Neutrophil < 1500/mm³.Response to treatment and dose reduction or discontinuation due to hematologic and extrahematologic toxicity were assessed. Results At a follow-up of 13 months, 49 pts were evaluable and 92% (45/49) of them were considered fit. The main criteria for starting therapy were anemia 39% (19/49) and splenomegaly 74% (36/42). At the time of analysis, 71% (35/49) pts completed pretreatment and rump-up. At 6 months, 53% (26/49 )of pts were evaluable for response. 73% (19/26) of them showed a CR and 26% (7/26)a PR. No disease progression was observed. Data were also confirmed at 12 months in the 8/26 pts evaluable at that time. Vaccinations for COVID-19, seasonal flu, HZV and pneumococcus were administered in 100%, 83%, 50%, 30%, respectively. Hypogammaglobulinemia was present in 20% 8.2% of patients presented infections that resolved without interruption of treatment. Only one showed the onset of arterial hypertension in the first 3 months, none arhythmic events, and only 1% presented hematomas and ecchymoses. Prophylaxis with G-CSF was started in 13/49(26%) pts at the fourth month. Temporary suspension of treatment for toxicity occurred in only 4/49 pts with I and 3/49 with V, respectively. One patient interrupted treatment with Ibrutinib due to intolerance. To date 48 pts are still on treatment. Conclusions Preliminary regional data mirror the outcomes seen in controlled trials (CAPTIVATE and GLOW study), showing promising rates of deep remission and tolerability in real-life. This descriptive paper aims to outline the Campania experience with frontline I+V in CLL, contextualizing local practice within the framework of international clinical evidence and highlighting future directions in the management of the disease