CLINICO-BIOLOGICAL PROFILE AND MANAGEMENT OF CHRONIC LYMPHOCYTIC LEUKEMIA

Abstract

Objective

Nearly 60%‒70% of patients with Chronic Lymphocytic Leukemia (CLL) are oligosymptomatic at diagnosis. The objective of the study was highlighting the clinical evolution and hematological patterns, as well as the assessment of short- and long-term results of treatment of patients with CLL.

Methodology

We realized a prospective and cohort study. The clinical-hematological features of CLL, the short- and long-term results of therapeutic management were studied in 62 patients, who were treated and followed up in the Institute of Oncology of Moldova between 2019‒2024. The study was related to the outpatient and hospitalized care. The diagnosis was proved according to the IWCLL criteria based on the complete blood count with the detection of lymphocytosis ≥ 5 × 10^9/l, bone marrow aspiration with lymphocytic infiltration ≥ 30% and immunophenotyping. The study was carried out on a basis of the data collected from the outpatient records and from the observation sheets of the patients according to the questionnaire drafted for the achievement of the settled objective. All patients were staged according to Binet and RAI Classifications.

Results

There were 25 (40.3%) males and 37 (59.7%) females in the study group. The age of the analyzed group was between 53 and 87-years (average age – 55.2-years). Forty-two (67.7%) patients with CLL belonged to the age category of 60‒79 years. The ECOG-WHO score at diagnosis was 2-3. Most of the patients (34% or 54.8%) were referred to hematologist in stage A. Twenty-three (37.1%) patients were diagnosed in stage B and 5 (8.1%) – in stage C. Nine (39.1%) cases of autoimmune hemolytic anemia and 8 (34.8%) cases of metaplastic anemia were revealed in stage B. Leukocytosis varied between 88.7‒325.0 × 10ꝰ/l (average value – 161.2 × 10ꝰ/l). Lymphocyte count ranged between 81%‒97% (average value 89%). Bone marrow aspiration in stages A and B revealed lymphocyte expansion of 33%‒91%. The respiratory bacterial infections turned out to be frequently diagnosed (29 patients, or 46.8%): acute pneumonia in 10 (16.1%), acute bronchitis in 7 (11.3%), relapse of chronic bronchitis in 11 (17.7%), and tuberculosis in 1 (1.7%) patient. The patients with progressive stage A, stage B and C disease received combined immuno-chemotherapy. Under the antineoplastic treatment, the ECOG-WHO score improved to 0‒1. Overall survival over 3 and 5 ears was 100%.

Conclusion

Our prospective study of CLL proved a predominance of female gender, patients of 60‒79 years old and stage A at diagnosis. The prognosis emerged to be relatively favorable, with the overall survival rates sustained at 100% within 3 and 5 years.