Supplementary materials: Assessment of second primary malignancies among treated and untreated patients with chronic lymphocytic leukemia using real-world data from the USA

<p dir="ltr"><b>These are peer-reviewed supplementary figures and tables for the article '</b><b>Treatment patterns and economic burden of bacterial vaginosis among commercially insured women in the USA</b><b>' published in the</b><b> </b><b><i>Journal of Comparative Effectiveness Research</i></b><b>.</b></p><ul><li><b>Supplementary Figure 1: </b>Timing of events for the treated and untreated subgroups</li><li><b>Supplementary Figure 2:</b> The covariate balance between the treated and untreated subgroups</li><li><b>Supplementary Table 1: </b>Procedure and NDC codes for CLL treatments</li><li><b>Supplementary Table 2: </b>Diagnosis codes for SPMs</li></ul><p dir="ltr"><b>Aim: </b>Improved management of chronic lymphocytic leukemia (CLL) has resulted in a growing population</p><p dir="ltr">of CLL survivors; these patients have a higher risk of developing second primary malignancies (SPMs) versus</p><p dir="ltr">the general population. This retrospective cohort study aims to assess the timing, frequency, incidence and</p><p dir="ltr">types of SPMs in treated and untreated patients with CLL in the USA, using the Surveillance, Epidemiology,</p><p dir="ltr">and End Results (SEER) Medicare database, which links a nationally representative cancer registry with</p><p dir="ltr">Medicare claims data. <b>Patients & methods:</b> Patients aged ≥66 years with newly diagnosed CLL between</p><p dir="ltr">1 January 2010 and 31 December 2016, who were enrolled in Parts A and B of Medicare for ≥12 months</p><p dir="ltr">pre-diagnosis of CLL were selected from the database. Patients were assessed for ≥36 months until the end</p><p dir="ltr">of continuous enrollment in Medicare Parts A, B and D, a switch to a health maintenance organization,</p><p dir="ltr">death, or end of the study period (December 2019). <b>Results:</b> Of 3053 patients included in the analyses,</p><p dir="ltr">620 (20.3%) were treated and 2433 (79.7%) were untreated within 36 months of diagnosis. Overall,</p><p dir="ltr">638 (20.9%) patients developed a SPM, 26.8% of patients in the treated cohort and 19.4% of patients</p><p dir="ltr">in the untreated cohort. The most common SPMs for both cohorts were squamous cell carcinoma and</p><p dir="ltr">acute myeloid leukemia. Among the 166 treated patients who developed a SPM, a greater proportion</p><p dir="ltr">developed their first SPM after treatment initiation versus those who developed their first SPM prior</p><p dir="ltr">to treatment initiation (p < 0.001). A significantly lower percentage of patients who received targeted</p><p dir="ltr">therapy developed a SPM (p < 0.05) versus patients treated with anti-CD20 + chemotherapy. Conclusion:</p><p dir="ltr">Findings indicate that treatment type and timing can affect SPM development in patients with CLL.</p><p dir="ltr">Combined with previous findings, this can help inform best practices in monitoring for SPM in patients</p><p dir="ltr">with CLL.</p>