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Chronic lymphocytic leukaemia at a county hospital in southern Sweden
V Hjalmar1, M Carlsson, E Kimby
1Department of Medicine, County Hospital Ryhov, Jönköping, Sweden.
Insights
This study of chronic lymphocytic leukemia (CLL) in Sweden found that incidental diagnoses were common. Survival was longer for untreated patients, and intercurrent diseases significantly impacted overall survival.
Area of Science:
- Hematology
- Oncology
- Epidemiology
Background:
- Chronic lymphocytic leukemia (CLL) is a common B-cell malignancy.
- Understanding the natural course of CLL in unselected populations is crucial for patient management.
- Geographically defined cohorts offer insights into disease incidence and outcomes.
Purpose of the Study:
- To describe the natural history and clinical characteristics of chronic lymphocytic leukemia (CLL) in a 10-year retrospective cohort.
- To evaluate survival rates and prognostic factors in an unselected CLL patient population.
- To assess the impact of comorbidities and treatment on CLL patient outcomes.
Main Methods:
- Retrospective analysis of 59 patients diagnosed with chronic lymphocytic leukemia (CLL) over a 10-year period in Jönköping, Sweden.
- Data collection included patient demographics, diagnostic methods (morphology and immunophenotyping), Rai/Binet staging, treatment status, and survival data.
- Analysis of comorbidities, secondary malignancies, and causes of death.
Main Results:
- The median age at diagnosis was 71 years, with a male:female ratio of 1.3:1.
- Most diagnoses (66%) were incidental, with 66% of patients in early Rai-stage O/I or Binet-stage A at diagnosis.
- Untreated patients had a median survival of 108 months, compared to 84 months for the whole cohort and 72 months for treated patients. 83% experienced infections, and 31% developed secondary malignancies.
Conclusions:
- Chronic lymphocytic leukemia (CLL) is often diagnosed incidentally at an early stage.
- Survival in CLL is influenced by treatment status and the presence of intercurrent diseases, which play a significant role.
- A substantial proportion of deaths in CLL patients are not directly attributable to the leukemia itself.
Abstract:
We have studied retrospectively patients with chronic lymphocytic leukaemia (CLL), at Ryhov, Jönköping, Sweden during a 10-year-period. This unselected cohort (n = 59) from a well-defined geographical area is suitable for describing the natural course of the disease. The CLL was diagnosed incidentally in the majority of cases. Median-age at diagnosis was 71 years and the male:female ratio was 1.3:1. The diagnosis was based on morphology in 66% and in 33% immunophenotyping specified the diagnosis of B- or T-CLL. At diagnosis 66% were in Rai-stage O/I or Binet-stage A. There were 36% untreated patients and their median-survival was 108 months compared with 84 months for the whole cohort and 72 months for the treated patients. Malignancies were seen in 31% and infections in 83%. Intercurrent diseases played an important role in the survival. During the observation time, only 54% of the deceased patients had died due to the CLL.