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Beta-Blockers Therapy is Associated with Shorter Time to First Treatments in Early-Stage Chronic Lymphocytic Leukemia

Tamar Tadmor1*, Guy Melamed2, Hilel Alapi2, Sivan Gazit2, Tal Patalon2, Lior Rokach3

Introduction: Beta blockers are among the most used class of drugs for the treatment of hypertension, arrythmias and congestive heart failure. Chronic Lymphocytic Leukemia (CLL) is the most frequent leukemia in western countries, and it involves elderly patients, who presents with past medical history including hypertension, arrythmias and heart disease.

Methods: In the current study, we aimed to retrospectively explore the effect of the use of beta-blocker, on Time To First Treatment (TTFT) in a large cohort of 3,474 patients with asymptomatic CLL who were under watch and wait approach. Data obtained from electronic medical records of Maccabi Healthcare Services (MHS) members, after receiving approval from the institution's ethical committee.

Results: Median follow-up of the entire cohort was 1745 days (57 months), and during this wait and watch period, 884 patients (25.4%) received a beta-blocker agent, for a minimum of 6 months. Bisoprolol Fumarate and Atenolol emerge as prominent treatments, representing 87.9% out of all of beta-blocker exposure. We report that utilization of any beta-blocker was associated with a shorter Time To First Treatment (TTFT), indicated by a hazard ratio of 1.5985 with a p-value of less than 0.001. The ten years treatment free ratio is 83.9% among beta-blockers users, while among non-beta-blocker users it is 90.4%.

Conclusion: The clinical observation, using a long-term retrospective study demonstrates that the administration of beta-blocker to patients with CLL in a watch and wait active surveillance is significantly associated with a shorter time to first treatment.