Retrospective evaluation of patients with chronic lymphocytary leukemia

Introduction: Chronic lymphocytic leukemia (CLL) is the most common leukemia in western countries. It occurs in elderly patients and has a highly variable clinical course. Most patients are asymptomatic at diagnosis. Some cases are characterized by palpable lymphadenopathies and/or splenomegaly requiring further investigation. Different prognostic markers are used. With the introduction of new targeted agents, the overall survival of patients with CLL has increased significantly. With this study, we aimed to shed light on physicians who conduct research in this direction and encounter patients in our country by determining the clinical features, prognostic factors, bone marrow morphology, genetic analysis, and response to treatment of patients diagnosed with CLL who were followed up and treated in our hospital. Material-method: A retrospective evaluation of the data obtained from the patient files in the hospital information system of 217 patients with a diagnosis of Uludağ University adult Hematology BD CLL between January 1, 2010 and January 1, 2020 at Uludağ University Health Application and Research Center was performed. Demographic, etiological features, risk factors, admission and laboratory findings (hemogram, ldh, beta-2 microglobulin), diagnosis and treatment characteristics of the patients were evaluated. Different chemotherapy median overall survival (OS) and progression free survival (PFS) values of the patients were calculated. Results: 55.8% (n:121) of the 217 patients included in the study were male, 44.2% (n:62) were female. The median age was 62. 167 of all patients were asymptomatic, 9.2% (n:20) of the patients had lymphadenopathy, 1.4% (n:3) had fever, 2.3% (n:5) had bacterial infections, 1.8% (n:4) had autoimmune hemolytic anemia (AIHA) and 7.8% (n:17) had weakness. Rai staging of the patients were assessed: 7.4% (n:16) were stage 0, 75.6% (n:164) were stage 1, 10.1% (n:22) were stage 2, 3.2% (n:7) were stage 3, 3.7% (n:8) were stage 4. Binet staging of the patients were assessed: 83.9% (n:182) were stage A, 10.1% (n:22) were stage B, 6% (n:13) were stage C. When the median laboratory findings of the patients were assessed: hemoglobin level was detected 13.1 gr/dl, leucocyte level was detected 26100/mm3, thrombocyte level was detected 197700/mm3, lymphocyte level was detected 20400/mm3, Ldh level was detected 193 U/L, erythrocyte sedimentation rate was detected10.5 mm/s, beta-2 microglobulin was detected 2.6 mg/L. The genetic analyses of the patients were assesed: 4.6% (n:10) were p53 positive, 57.1% (n:124) were p53 negative. 13q deletion features of the patients were assessed: 7.4% (n:16) had 13q deletion, 28.1% (n:61) had no 13q deletion. 11q deletion features of the patients were assessed: 194 patients (%89.4) were not investigated of 11q deletion, 23 patients (%10.6) had no 11q deletion. Conclusion: In the light of the information obtained in the long-term follow-up and treatment examinations of CLL patients, Rai and Binet stages, prognostic factors, genetic analyzes with FISH and clinical conditions should be considered and evaluated in terms of treatment necessity, and the choice of either targeted or conventional chemotherapy should be directed towards the patient. Appropriate chemoimmunotherapies should be started on time for our patients who can handle remission-targeted therapy. Keywords: Chronic Lymphocytic Leukemia, Overall Survival, Treatment