The effect of prognostic features of patients with chronic lymphocytic leukemia on overall survival and treatment-free survival: A single-center experience

Abstract

Chronic lymphocytic leukemia (CLL) is a disease with a highly variable clinical spectrum and prognosis, and is more common in the elderly population. The identification of high-risk patients according to prognostic factors and the application of new treatment regimens have improved survival in CLL. The purpose of our study was to examine the effects of important prognostic factors on survival in patients with CLL in our patient population. Treatment-free survival (TFS) and overall survival (OS) analyses were performed in patients diagnosed with CLL between January 2000 and June 2013 according to clinical characteristics at the time of diagnosis, bone marrow infiltration pattern, lactate dehydrogenase (LDH) and beta 2-Microglobulin levels, CD38 expression and fluorescent insitu hybridization (FISH) findings. Two hundred and forty-five patients were evaluated. Presence of initial B symptom, Rai stage>I, Binet stage B and C, diffuse infiltration of bone marrow by lymphocytes, LDH, and beta 2-Microglobulin levels above upper limit of normal (ULN), and CD38 positivity shortened both TFS and OS (p<0.05). Also, age over 65 years, performance score of 2 and above, and del17p positivity shortened OS (p<0.05) but did not make a statistically significant difference in TFS. In multivariate analysis, it was determined that advanced age was an independent poor prognostic factor affecting OS, and Rai stage was an independent risk factor affecting TFS (p<0.05). When Rai stage was excluded, beta 2-Microglobulin and LDH were found to be negative prognostic risk factors affecting TFS independent of other factors. LDH level, which is not included in the international prognostic scoring system, was found to be a marker affecting TFS and OS in our study.

Keywords

• chronic lymphocytic leukemia
• prognosis
• survival
• lactate dehydrogenase
• beta 2-Microglobulin

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