Evaluation of treatment response according to CD38 level of patients with chronic lymphocytic leukemia receiving ritüksimab-bendamustin- cyclophosfamide and ritüksimab-fludarabin treatment in primary stage

Introduction-Purpose: CLL is a lymphoproliferative malignancy characterized by an abnormal increase of mature B lymphocytes, often seen in the elderly population. In our study, we aimed to evaluate the treatment response and survival of patients who received Ritüksimab-Bendamustin- Cyclophosfamide and Ritüksimab-Fludarabin in primary care, especially according to CD38 level. Results: In the study, 74 of 209 patients were female and 135 were male, and the mean age of the patients was calculated as 66,7. The mean Hgb of the patients was 12,9, the mean Plt was 188500, the mean WBC was 55,0, the mean lymphocyte value was 42,1, the mean LDH value was 253,4, and the mean CD38 was 14,1. Anemia was observed in 7,7% of the patients and thrombocytopenia was observed in 15.8% of the patients. It was determined that 12.4% of the patients had a CD 38 result above 30%. Splenomegaly was observed in 58,9% of the patients, and hepatomegaly was observed in 39,9% of the patients. LAP was present in 73,7% of the patients. Comorbidity was present in 89 (42.6%) of the patients. Majority of the patients, 76, were RAI Stage 2 (36.4%), 110 (52.6%) of the patients were compatible with BINET Stage A. 88 (42.1%) of the patients were ECOG 2, which makes up the majority. It has been observed that more than 50% of the patients live without the need for treatment in the first year, and approximately 25% in the first 5 years. Of the patients, 119 (56,9%) received treatment, of which 36 (30.3%) received R-FC, 11 (9.2%) RB, and 72 (60,5%) other treatments. In the first step, PFS was found to be 31.6 in R-FC patients, 18.4 in RB patients, OS 60.0 in all patients, 54.5 months in TFS and 34.4 months in need for treatment. Age (p=0.061), duration of treatment need (p=1,000), ECOG (p=0.665), OS (p=0.143), PFS (p=0.075), TFS between those who received R-FC as first-line therapy and those who received RB There was no significant difference in terms of (p=0.158) and comorbidity (p=0.737). There was no significant difference between CD38 results in terms of survival and need for treatment (p>0.05). There was no significant difference in survival between patients who received treatment and those who did not (p=0.553). In CD38 negative patients, R-FC PFS was found to be significantly higher than RB PFS (p=0.027). There was no significant difference in terms of PFS between those who received R-FC and those who received R-B in CD38 positive patients (p=0.661). Conclusion: As a result, high-risk patients can be identified by evaluating prognostic factors in addition to the disease stage at the diagnosis stage. In our study, we investigate the relationship of CD38, one of the prognostic factors, with the prognosis of the disease and treatment response.