[Chronic lymphatic leukemia. A population-based study of symptoms, findings, complications and choice of treatment]

224 patients with a recent diagnosis of chronic lymphocytic leukemia, confirmed by immune phenotype, were studied with a mean follow-up of 16 months. The median age was 72 years and the ratio of men to women was 1.51. An incidental diagnosis because of leukocytosis was made in 75% of the patients; in only 22% was the diagnosis related to symptoms. 80% were in stage A, 7.5% in stage B, and 12.5% in stage C. A relation was found between advanced stage and the number of lymphocytes in the blood, the percentage of lymphocytes in the bone marrow, WHO performance status, bacterial infection and disease-related mortality. Thus, six patients in stage C (21%) died because of infection (septicaemia or pneumonia), as opposed to only one out of 196 patients in stages A and B. The incidence of bacterial infection was 64% in stage C, as compared to 8.3% in stage A. Treatment with chlorambucil, started in 59 patients, was in accordance with the guidelines of the national programme for 52 of them. In contrast, a strict indication for prednisone (autoimmune cytopenia) was found in only 42% of 42 patients given this treatment.