Follow Up of Sixty Patients with Chronic Lymphocytic Leukaemia

Abstract

ABSTRACT: BACKGROUND: Chronic lymphocytic leukemia(CLL) is heterogeneous in its clinical course and typicallydiagnosed when patients presented with symptoms of lymphadenopathy, cytopenia ,constitutionalsymptoms or infection. Now 50% of patients with CLL are likely to be diagnosed when an elevatedlymphocyte count is discovered incidentally .OBJECTIVE: Description of various presentation in adult patients with CLL, complications that happenedduring the course of their disease, cause of death and overall survival in these patients.PATIENTS AND METHODS: Sixty Iraqi adult patients with CLL were studied retrospectively and prospectively. These patientswere assessed clinically and stratified with Rai staging, with follow up for any complications thatoccurred during their course of disease from time of diagnoses till last visit or death. RESULTS: In this study, the age group more than fifty years form 50(83.3%) patients and those less than fiftyform 10(16.6%) patients. The commonest clinical feature reported was constitutional symptoms in19(31.6%)patient. Rai staging of these patients found to be that most of patients intermediate stageII 22(36%) and advanced stage III, IV in 34(56.6%) Regular follow up of these patients revealed that autoimmune disorder occur in 6(10%) patients, inform of autoimmune hemolytic anemia (AIHA),pure red cell aplasia (PRCA)and immunethrmbocytopenia (ITP).The increase susceptibility to infection by different viral , bacterial andparasitic infection was noticed in these patients during their course of illness. Death in thesepatients was due to infection with HBV and liver failure in 2(3%)patients, obstructive jaundice andhepatic encephalopathy in one(1.6%)patients, sepsis in 4(6.6%), bleeding in one (2.04%) ,renalfailure in two patients (1.6%),chronic sinusitis with fungal infection and renal failure in one (1.6%)patient ,Richeters transformation and disease progression in 7(11.6%) or due to co morbidillness (stroke, ischemic heart disease, heart failure ) in 3(5%) patients. The overall survival forthese patients within five years was 50% .CONCLUSION :Constitutional symptoms was the commonest presentation of CLL Iraqi patients. The indolentcourse of the disease in CLL patients, still can be interrupted by different complications includinginfection, autoimmune disorder, and malignancy.