KRONİK LENFOSİTİK LÖSEMİ/LENFOMA TANILI HASTALARIMIZIN RETROSPEKTİF DEĞERLENDİRİLMESİ

Yıl 2016, Cilt: 20 Sayı: 3, 87 - 94, 01.09.2016

Şerife Solmaz Medeni Tugba Çetintepe Sinem Namdaroğlu Rumeysa Sarı Merve Koçar Ebru Özden Oktay Bilgir

Öz

Giriş: Çalışmamızda Bozyaka Eğitim ve Araştırma Hastanesi Hematoloji Kliniğinde takip edilen 91 kronik lenfositik lösemili hastanın demografik verileri, tedavi endikasyonları, tedavi yanıtları ile sağkalım analizlerinin yapılması amaçlandı. Gereç ve Yöntem: Kronik Lenfositik Lösemi/Lenfoma tanısı ile izlenen 91 olgunun verileri geriye dönük olarak değerlendirildi. Bulgular: Çalışmaya alınan 91 hastadan 48'i erkek, 43'ü kadındı. Ortanca yaş 67 olarak saptandı.57 hasta tedavisiz izlenirken, 34 hasta tedavi aldı. 21 hasta Ritüksimab, fludarabin, siklofosfomid R- FC , 6 hasta Fludarabin, sikolofosfomid FC , 5 hasta Ritüksimab-Klorombusil, 1 hasta Fludarabin, mitaksantron, siklofosfomid FMC ve 1 hasta Ritüksimab, siklofosfomid, vinkristin, prednizolon R-CVP tedavisi aldı. Hastaların 18 tanesi ölmüş, 74 tanesi ise yaşıyor olarak saptandı. Tüm KLL hastalarında ortalama sağkalım süresi 45 ay olarak bulundu. 1 yıllık sağkalım %95, 5 yıllık sağkalım % 41 olarak saptandı. Sonuç: Hastalarımızın demografik özellikleri diğer çalışmalar ile benzerdir. Tedavi alan gruptaki sağkalım daha yüksek bulunuştur. Bununla beraber çalışmamızda toplam sağkalım süresi literatürdekilerden daha kısa bulunmuştur

Anahtar Kelimeler

Kronik lenfositik lösemi/lenfoma, prognoz

RETROSPECTIVE EVALUATION OF OUR PATIENTS WITH DIAGNOSIS CHRONIC LYMPHOCYTIC LEUKEMIA/LYMPHOMA

Öz

Introduction: Demografic features, treatment endications, respond the treatment of 91 chronic lymphocytic leukemia CLL patients observed at depertman of hematology, Bozyaka Traning and Research Hospital in our study. Material and Method: Data of 91 CLL patients were evaluated retrospectively. Results: We found that 43 of the patients were women and 48 of the patients and were men and median age were 67. While 34 patients received treatment, 57 patients were observed. 21 patients were treated by R-FC , 6 patients by FC, 5 patients by R-Klorombucil, 2 patients by FMC and R-CVP.18 patients died, and 74 of them lived.We found the median survival 45 months all of the patients. All patients survival OS was 95% of one year and 5 years overall survival rates 41%. Conclusion: Demografic features of patients are similar to another studies. The survival were higher in the treatment group. However, in our study was significantly shorter overall survival than those in the literature

Anahtar Kelimeler

Chronic lymphocytic leukemia/ lymphoma, prognosis

Kaynakça

• Hallek M, Cheeason BD, Catovsky , Caligaris-Cappio F, Dighiero G, Döhner H, et al. Guidelines for the diagnosis and treatment ef chronic lymphocytic leukemia: a report from the International Workshop on Chronic Lymphocytic Leukemia updating the National Cancer Institute-Working Group 1996 Guidelines. Blood 2008;111(12):5446-56.
• Soysal T. Kronik Lenfositik Lösemi/KLL, Tanı, Tedavi. Türk Hematoloji Derneği,Hematolog 2013;3:253-70.
• Yee KW, O’Brien SM. Chronic lymphocytic leukemia:diagnosis and treatment. Mayo Clin Proc 2006;81(8):279-84.
• Pamuk ON, Pamuk GE, Soysal T, Ongören S, Başlar Z, Ferhanoğlu B, et al. Chronic lymphocytic leukemia in Turkey:experience of a single center in Istanbul. South Med J 2004;97(3):240-5.
• Horner MJ, Ries LAG, Krapcho M, Neyman N, Aminou R, Howlader N, et al. SEER Cancer Statistics Review,1975-2006. National Cancer Institute;Bethesda, MD:2009
• Rai KR, Sawitsky A, Cronkite EP, Chanana AD, Levy RN, Pasternack BS. Clinical staging of chronic lymhocytic leukemia. Blood 1975;46(2):219-34.
• Binet JL, Auguier A, Dighiero G. Chastang C, Piguet H, Goasguen J, et al. A new prognostic classificatıon of chronic lymphocytic leukemia derived from a multivariate survival analysis. Cancer 1981;48(1):198-206.
• Montserrat E. New prognostic markers in CLL. Hematology Am Soc Hematol Educ Program 2006;279-84.
• Rosenquist R, Cortese D, Bhoi S, Mansouri L, Gunnarsson R. Prognostic markers and their clinical applicability in chronic lymphocytic leukemia: where do we stand? Leukemia,Lymphoma 2013;54(11):2351-64.
• Döhner H, Stilgenbaur S, Benner A. et al. Genomic aberrations and survival in lymphocytic leukemia: a meta-analysis of the randomized trails. J Natl Cancer Inst 1999;91:861-8.
• Pamuk GE, Pamuk ON, Soysal T. Ongören S, Başlar Z, Ferhanoğlu B, et al. An overwiev of young CLL patients: a single- centre experience from Turkey. Haematologia 2002;31(4):303-11.
• Demir V, Kahraman S, Katgı A, Pişkin Ö, Özsan GH, Demirkan F, et al. Kronik lenfositik lösemi hastarının genel klinik değerlendirilmesi. Dokuz Eylül Üniversitesi Tıp Fakültesi Dergisi 2012;26(1):9-19.
• Dores GM, Anderson WF, Curtis RE, Landgren O, Ostroumova E, Bluhm EC, et al. Chronic lymphocytic leukemia and small lymphocytic lymphoma:overview of the descriptive epidemiology. Br J Haematol 2007;139(5):809-19.
• Oscier DG, Manutes E, Copplestone A, Pickering RM, Chapman R, Gillingham R, et al. Atypical lymphocyte morphology: an adverse prognostic factor for disease progression in stage A CLL independent of trisomy 12. Br J Haematol 1997;98(4):934-9.
• Lee JS, Dixon DO, Kantarjian HM, Keating MJ, Talpaz M. Prognosis of chronic lymphocytic leukemia: a multivariate regression analysis of 325 untreated patients. Blood 1987;69(3):929-36.
• Richter MN. Generalized reticuler cell sarcoma of lymph nodes associated with lymphatic leukemia.Am J Pathol 1928;4(4):285-92.
• Krause MD, Drinkard LC, Keglovits LC. Hodgkin lymphoma treansformation of chronic lymphocytic leukemiasmall lymhocytic lymphoma. Bayl Univ Med Center 2013;26(1):16-8.
• Kazmierczak M, Kroll-Balcerzak R, Balcerzak A, Czechowska E, Gil L, Sawiński K, et al. Hodgkin Lymphoma transformatıon of chronic lymphocytic leukemia: cases report and discussion. Med Oncol 2014;31(1):800-8.
• Moreno C, Hodgson K, Ferrer G, Elena M, Filella X, Pereira A, et al. Autoimmüne cytopenia in chronic lymphocytic leukemia: prevalence clinical associations and prognostic significance. Blood 2010;116(23) :4771-6.
• Visco C,Ruggeri M, Evangelista LM, Stasi R, Zanotti R, Giaretta I, et al. Impact of immune thrombocytopenia on the clinical course of chronic lymphocytic leukemia. Blood 2008;111(3): 1110-6.
• Cooperative Group for the study of Immunglobulin in Chronic Lymphocytic Leukemia. Intravenous immunoglobulin for the prevention of infection in chronic lymphocytic leukemia. A randomized controlled clinical trial. N Engl J Med 1988;319(14):902-7.
• Vladareanu AM, Ciufu C, Neagu AM, Onisai M, Bumbea H, Vintilescu AM, et al. The impact of hepatitis viruses on chronic lymphopoliferative disorders- preliminary results. J Med Life 2010;3(3):320-9. 94
• İzmir Eğitim ve Araştırma Hastanesi Tıp Dergisi (Medical Journal of İzmir Hospital)