DOI QR코드

DOI QR Code

Survival and Clinical Aspects for Patients with Chronic Lymphocytic Leukemia in Kermanshah, Iran

  • Payandeh, Mehrdad (Department of Hematology and Oncology, Kermanshah University of Medical Sciences) ;
  • Sadeghi, Edris (Cancer Research Center, Kermanshah University of Medical Sciences) ;
  • Sadeghi, Masoud (Medical Biology Research Center, Kermanshah University of Medical Sciences)
  • Published : 2015.12.03

Abstract

Chronic lymphocytic leukemia (CLL)is the most common leukemia in adults in Western countries but is relatively rare in Asia. Immune hemolytic anemia, Evan's syndrome, lymphadenopathy, organomegaly and B symptoms are the main complaints of patients in CLL. The present retrospective analysis evaluated a group of 109 patients with CLL over a 9-year period, studying correlations between sex, age and overall survival. The patients were hospitalized in the Clinic of Hematology and Oncology, Kermanshah, Iran, between 2006 and 2014. Data analysis for sex and age was performed using IBM SPSS19 and overall survival was plotted by Kaplan-Meier plot, Log-rank test in Graph Pad prism 5 Software for five-year periods. The mean age of diagnosis for CLL patients was 60.73 years, 59.6% male. Survival rate patients was 64% and mean overall survival was 38.5 months. In the Rai system, fourteen patients (12.8%) had stage III and twenty eight patients (25.7%) had stage IV. Most frequent clinical features in patients with CLL were lymphadenopathy (38.7%) and organomegaly (34%), respectively. There is not relationship between sex and age in patients but overall survival rate in females was higher than in males. In Asian countries, CLL is more in male and in age above 60 years. Complaints about lymphadenopathy and virus infection are prevalent.

Keywords

References

  1. Agrawal N, Naithani R, Mahapatra M, et al (2007). Chronic lymphocytic leukemia in India--a clinico-hematological profile. Hematol, 12, 229-33. https://doi.org/10.1080/10245330701255064
  2. Aozasa K, Ohsawa M, Horiuchi K, et al (1991). Intermediate lymphocytic lymphoma: its frequency and characteristics in Japan. J Surg Oncol, 48, 268-71. https://doi.org/10.1002/jso.2930480410
  3. Azarm T, Fazilati M, Azarm H, et al (2013). Serum selenium levels in chronic lymphocytic leukemia. Adv Biomed Res, 2, 44. https://doi.org/10.4103/2277-9175.114177
  4. Binet JL, Auquier A, Dighiero G, et al (1981). A new prognostic classification of chronic lymphocytic leukemia derived from a multivariate survival analysis. Cancer, 48, 198-206. https://doi.org/10.1002/1097-0142(19810701)48:1<198::AID-CNCR2820480131>3.0.CO;2-V
  5. Catovsky D, Wade R, Else M (2014). The clinical significance of patients' sex in chronic lymphocytic leukemia. Haematologica, 99, 1088-94. https://doi.org/10.3324/haematol.2013.101378
  6. Chaudhary RK, Das SS (2014). Autoimmune hemolytic anemia: From lab to bedside. Asian J Transfus Sci, 8, 5-12. https://doi.org/10.4103/0973-6247.126681
  7. Chim CS, Fung TK, Wong KF, et al (2006). Frequent DAP kinase but not p14 or Apaf-1 hypermethylation in B-cell chronic lymphocytic leukemia. J Hum Genet, 51, 832-8. https://doi.org/10.1007/s10038-006-0029-x
  8. Dosi RV, Ambaliya AP, Patell RD, et al (2012). A case report of Evans Syndrome. Indian J Med Sci, 66, 82-5. https://doi.org/10.4103/0019-5359.110920
  9. Durak B, Akay OM, Aslan V, et al (2009). Prognostic impact of chromosome alterations detected by FISH in Turkish patients with B-cell chronic lymphocytic leukemia. Cancer Genet Cytogenet, 188, 65-9. https://doi.org/10.1016/j.cancergencyto.2008.08.019
  10. Goede V, Fischer K, Busch R, et al (2014). Obinutuzumab plus chlorambucil in patients with CLL and coexisting conditions. N Engl J Med, 370, 1101-10. https://doi.org/10.1056/NEJMoa1313984
  11. Gogia A, Raina V, Gupta R, et al (2014). Prognostic and predictive significance of smudge cell percentage on routine blood smear in chronic lymphocytic leukemia. Clin Lymphoma Myeloma Leuk, 14, 514-7. https://doi.org/10.1016/j.clml.2014.02.007
  12. Gogia A, Sharma A, Raina V, et al (2013). Prevalence of ZAP-70 and CD 38 in Indian chronic lymphocytic leukemia patients. Indian J Cancer, 50, 333-6. https://doi.org/10.4103/0019-509X.123620
  13. Iwatani K, Takata K, Sato Y, et al (2014). Low-grade B-cell lymphoma presenting primarily in the bone marrow. Hum Pathol, 45, 1379-87. https://doi.org/10.1016/j.humpath.2014.02.010
  14. Kawamata N, Moreilhon C, Saitoh T, et al (2013). Genetic differences between Asian and Caucasian chronic lymphocytic leukemia. Int J Oncol, 43, 561-5. https://doi.org/10.3892/ijo.2013.1966
  15. Kermani IA, Dehdilani M, Dolatkhah R (2007). Chronic lymphocytic leukemia in the recent 10 years and treatment effects of Fludarabin. Asian Pac J Cancer Prev, 8, 367-71.
  16. King D, Ramachandra J, Yeomanson D (2014). Lymphadenopathy in children: refer or reassure? Arch Dis Child Educ Pract Ed, 99, 101-10. https://doi.org/10.1136/archdischild-2013-304443
  17. Maffei R, Bulgarelli J, Fiorcari S, et al (2014). Endothelin-1 promotes survival and chemoresistance in chronic lymphocytic leukemia B cells through ETA receptor. PLoS One, 9, 98818. https://doi.org/10.1371/journal.pone.0098818
  18. Marotta G, Bucalossi A, Galieni P, et al (1998). CD4+/CD45RA+ 'naive' T cells and immunological response to influenza virus vaccine in B-cell chronic lymphocytic leukaemia patients. Acta Haematol, 99, 18-21. https://doi.org/10.1159/000040709
  19. Maura F, Visco C, Falisi E, et al (2013). B-cell receptor configuration and adverse cytogenetics are associated with autoimmune hemolytic anemia in chronic lymphocytic leukemia. Am J Hematol, 88, 32-6. https://doi.org/10.1002/ajh.23342
  20. Milani C, Dalia SM, Colvin GA (2009). Thromboembolic complications of intravenous immunoglobulin (IVIG) in an immunocompromised patient with chronic lymphocytic leukemia: a case report. Cases J, 2, 9078. https://doi.org/10.1186/1757-1626-2-9078
  21. Mittal S, Blaylock MG, Culligan DJ, et al (2008). A high rate of CLL phenotype lymphocytes in autoimmune hemolytic anemia and immune thrombocytopenic purpura. Haematologica, 93, 151-2. https://doi.org/10.3324/haematol.11822
  22. Muirhead CR, O'Hagan JA, Haylock RG, et al (2009). Mortality and cancer incidence following occupational radiation exposure: third analysis of the national registry for radiation workers. Br J Cancer, 100, 206-12. https://doi.org/10.1038/sj.bjc.6604825
  23. Osmani AH, Masood N (2013). Single centre study of using bendamustine in the treatment of B-cell malignancies. J Pak Med Assoc, 63, 702-6.
  24. Pamuk ON, Pamuk GE, Soysal T, et al (2004). Chronic lymphocytic leukemia in Turkey: experience of a single center in Istanbul. South Med J, 97, 240-5. https://doi.org/10.1097/01.SMJ.0000053674.03385.B7
  25. Rai KR, Sawitsky A, Cronkite EP, et al (1975). Clinical staging of chronic lymphocytic leukemia. Blood, 46, 219-34.
  26. Rossignol J, Michallet AS, Oberic L, et al (2011). Rituximabcyclophosphamide- dexamethasone combination in the management of autoimmune cytopenias associated with chronic lymphocytic leukemia. Leukemia, 25, 473-8. https://doi.org/10.1038/leu.2010.278
  27. Sarkar PK, Malhotra P, Sriram PS (2014). Rapid progression of pulmonary blastomycosis in an untreated patient of chronic lymphocytic leukemia. Case Rep Med, 2014, 514382.
  28. Shanafelt TD, Bowen DA, Venkat C, et al (2009). The physicianpatient relationship and quality of life: lessons from chronic lymphocytic leukemia. Leuk Res, 33, 263-70. https://doi.org/10.1016/j.leukres.2008.06.019
  29. Siddon AJ, Rinder HM; Education Committee of the Academy of Clinical Laboratory Physicians and Scientists (2013). Pathology consultation on evaluating prognosis in incidental monoclonal lymphocytosis and chronic lymphocytic leukemia. Am J Clin Pathol, 139, 708-12. https://doi.org/10.1309/AJCPLIR4GZWX3XKA
  30. Stephens DM, Ruppert AS, Blum K, et al (2012). Flavopiridol treatment of patients aged 70 or older with refractory or relapsed chronic lymphocytic leukemia is a feasible and active therapeutic approach. Haematologica, 97, 423-7. https://doi.org/10.3324/haematol.2011.047324
  31. Van der Velden AM, Mulder AH, Hartkamp A, et al (2001). Influenza virus vaccination and booster in B-cell chronic lymphocytic leukaemia patients. Eur J Intern Med, 12, 420-4. https://doi.org/10.1016/S0953-6205(01)00149-2
  32. Woyach JA, Ruppert AS, Rai K, et al (2013). Impact of age on outcomes after initial therapy with chemotherapy and different chemoimmunotherapy regimens in patients with chronic lymphocytic leukemia: results of sequential cancer and leukemia group B studies. J Clin Oncol, 31, 440-7. https://doi.org/10.1200/JCO.2011.41.5646
  33. Wu T, Li ZJ, Wang YF, et al (2009). [Prognostic factor analysis in 203 patients with chronic lymphocytic leukaemia]. Zhonghua Xue Ye Xue Za Zhi, 30, 435-9.
  34. Zhu Y, Qin Q, Xie Z (2013). Efficacy of oral fludarabine in patients with chronic lymphocytic leukemia/small lymphocytic lymphoma. Zhong Nan Da Xue Xue Bao Yi Xue Ban, 38, 221-4.