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[Chronic lymphoproliferative syndromes in Chile. A prospective study in 132 patients]
María Elena Cabrera1, Neda Marinov, Carolina Guerra
1Departamento de Medicina, Campus Oriente, Facultad de Medicina, Universidad de Chile, Servicio de Medicina, Hospital del Salvador, Santiago. mcabrera@mi-mail.cl
Insights
Chile shows a lower incidence of chronic lymphocytic leukemia (CLL) and a higher rate of adult T-cell leukemia/lymphoma (ATLL) compared to other Western countries. This may be due to patient selection or underdiagnosis of asymptomatic CLL cases.
Area of Science:
- Hematology
- Oncology
- Epidemiology
Context:
- Chronic lymphoproliferative disorders present diagnostic challenges for hematologists.
- Understanding the geographical distribution of these disorders is crucial for public health initiatives.
Purpose:
- To prospectively investigate the incidence and distribution of chronic lymphoproliferative disorders in Chile.
- To compare Chilean epidemiological data with Western, Latin American, and Oriental countries.
Summary:
- A 36-month study of 132 patients revealed a median age of 63, with 82% B-cell and 18% T-cell tumors.
- Chronic lymphocytic leukemia (CLL) accounted for 45% of B-cell tumors; disseminated lymphomas were also observed.
- Adult T-cell leukemia/lymphoma (ATLL) was the most common disorder, consistent with high HTLV-1 seroprevalence in Chile.
Impact:
- The study highlights a lower incidence of CLL and a higher prevalence of ATLL in Chile compared to Western nations.
- Findings suggest potential underdiagnosis of asymptomatic CLL and underscore the impact of HTLV-1 infection on T-cell leukemia incidence.
- This research provides valuable epidemiological insights for regional and global hematological oncology.
Background:
Chronic lymphoproliferative disorders include a variety of diseases which are often a diagnostic problem for clinical hematologists.
Aim:
To study prospectively the distribution and incidence of chronic lymphoproliferative disorders in Chile and compare them with those of other Western, Latin American and Oriental countries.
Patients And Methods:
A group of 132 patients were studied in a 36 months period (1999-2001), with a panel of monoclonal antibodies. A score for chronic lymphocytic leukemia was employed to differentiate it from other B-cell disorders.
Results:
The median age was 63 years old (range 32-94). Most patients had B-cell tumors (109) and the rest (23), T-cell tumors (82% vs 18%). Forty five percent of patients with B-cell tumors had a chronic lymphocytic leukemia (CLL), while the others were disseminated lymphomas. The incidence of T-cell tumors was slightly higher than that of other Western countries. Noteworthy is that the most common of these disorders was adult T cell leukemia/lymphoma (ATLL), in concordance with the high HTLV-1 seroprevalence in Chile.
Conclusions:
A morphologic, immunophenotypic and pathological study in a large number of patients with chronic lymphoproliferative disorders in Chile, shows a relatively low incidence of CLL when compared to other chronic B-cell tumors and a high representation of ATLL associated to HTLV-1 infection, compared with other Western countries. The lower incidence of CLL in our study might be due to patient's selection and/or underdiagnosis of this disease as a substantial proportion of CLL are asymptomatic.