17p genetic status of chronic lymphocytic leukemia patients, survival effects according to their stages and retrospective investigation of the treatments that they received

17p GENETIC STATUS OF CHRONIC LYMPHOCYTIC LEUKEMIA PATIENTS, SURVIVAL EFFECTS ACCORDING TO THEIR STAGES AND RETROSPECTIVE INVESTIGATION OF THE TREATMENTS THAT THEY RECEIVED Purpose: CLL is a disease characterized by monoclonal proliferation and accumulation of neoplastic B lymphocytes in peripheral blood, bone marrow, lymph nodes and spleen. In this study, we aimed to investigate the demographic characteristics, disease stages, 17p deletion status and survival according to various factors of patients diagnosed with CLL in our clinic and compare them with the literature. Methods: The data of 308 patients diagnosed with CLL in the internal medicine hematology clinic of Dicle University between January 1, 2015, and January 1, 2021, were analyzed retrospectively. The general characteristics, laboratory values, disease stages, genetic results of 17p deletion, treatment options and survival times of the patients included in the study were investigated. Results: Of the 308 patients included in the study, 190 (61.7%) were male and 118 (38.3%) were female. The male/female ratio was 1.6/1, the mean age was 62.7 (median age 63), and the standard deviation was 10.7. The age range was found to be between 28 and 86 years. 17p deletion was studied in 170 patients, and the result of 26 patients was determined as positive (15.3%). When the distribution of the patients according to Rai staging at the time of diagnosis was examined, 8.4% of the patients were stage 0, 42.2% stage I, 30.5% stage II, 12.5% stage III, 6.5%. I was determined as stage IV. The median value of the follow-up period was calculated as 68.1 months (min-max=3.1-186.6 months). During the follow-up, Richter transformation was observed in 9 (2.9%) patients, AIHA in 31 (10.1%) patients, ITP in 6 (1.9%) patients, and secondary immunodeficiency in 58 (18.8%) patients. It was observed that 109 (35.4%) patients did not receive treatment during their follow-up, and 199 (64.6%) patients received treatment. The median value of treatment-free survival was calculated as 21.2 months (95%CI=16.9-25.4). It was observed that the treatment-free survival time was declined as the Rai stage increased (p<0.001). The treatment-free survival time of those with normal LDH levels was 29.4 months (95%CI=20.6-38.3), while the treatment-free survival time of those with high LDH levels was 13.9 months (95%CI=10.5-17.4) (p=0.03). The treatment-free survival time of patients with positive 17p deletion was 10.5 (95%CI=0-21.3), while those with negative 17p deletion had a 21 (95%CI=15.7-26.3) survival time (p=0.03). During the follow-up of 308 patients included in the study, 118 (38.3%) died. The median value of overall survival time of the patients was calculated as 117.2 months (95%CI=104.-129.9). It was observed that as the Rai stage of the patients increased, the overall survival decreased (p=0.001). The median value of overall survival value of patients with high LDH value was 84.5 months (95%CI=70.2-98.7), and it was 128.7 (95%CI=114.5-142.8) months in patients with normal (p<0.001). The median value of overall survival time of patients with positive 17p deletion was 83.4 months (95%CI=52.9-114) and patients with negative 17p deletion were 116 months (95%CI=92.6-139.4) (p=0.015). The median value of overall survival of patients with Richter transformation was 90.1 months (95.CI=20.5-159.4), while the median total survival of patients without Richter transformation was 118.3 months (95.CI=105.1-131.5). observed (p=0.037). Conclusion: CLL is a disease of advanced age and is more common in men. In our study, in accordance with the literature, most of our patients were elderly patients and male predominance was in the foreground. The 17p deletion positivity of the patients was 15.3%, and 17p deletion was observed to be a poor prognostic factor. It was observed that as the stages of the patients increased, their untreated and overall survivals were decreased.