CLL-012: Diagnosis and Treatment Options in Low-Risk Chronic Lymphocytic Leukemia

Context: Chronic lymphocytic leukemia (CLL) is an actual issue of hemato-oncology due to the increase in morbidity rates, frequent relapses, autoimmune and infectious complications. Objective: To study the diagnostic features, short- and long-term results of treatment in low-risk CLL. Design: The study enrolled 82 patients with low-risk CLL aged at 45-86 years (median age - 66.2 years), treated at the Institute of Oncology in 2000-2020. The diagnosis was asserted by immunophenotyping and detection of lymphocytosis in the blood smear and bone marrow aspirates. Setting: The study was related to the outpatient and in-patient care. Patients: There were registered commonly males (57.3%) and age groups of 60-79 years. According to Binet classification, 54 (65.9%) patients were revealed in stage A, and 28 (34.1%) in stage B. Main Outcomes Measures: The response to treatment should be asserted by the survival and progression rates. Interventions: Single-agent chemotherapy with chlorambucil was performed in older patients, with concomitant pathology. COP and CHOP chemotherapy was performed in stage C. Results: Transformation into stage B occurred in 22 (40.8%) patients with stage A in the period of 1-4 years. The CLL progression into stage C was found in 10 (37.7%) patients with stage B. Peripheral lymphadenopathy was revealed in 27 (96.4%) patients, splenomegaly in 22 (78.6%), hepatomegaly in 13 (46.4%). Infectious complications were detected in 11 (20.4%) cases. Autoimmune hemolytic anemia was diagnosed in 9 (32.1%) stage B patients. Partial responses were achieved for 4-6 months after chlorambucil chemotherapy. 16 (19.5%) patients were followed up to fatal outcomes within 3-19 years, including 5 (31.3%) due to the CLL progression and 5 (31.2%) due to secondary tumors. The overall one-, 3- and 5-year survival was 98.0%, 91.2% and 77.3%, respectively. The one-, 3- and 5-year survival in stage A patients was equal to 100%, 100% and 95.7%; in stage B, 96.4%, 84.8% and 55.4%, correspondingly. Conclusions: CLL was diagnosed commonly in males, aged 60-79 years and in stage A. The survival rates depended on a clinical stage and accounted 98.0% at one year and 77.3% at 5 years.