Clinical and Biological Features of Chronic Lymphocytic Leukemia A Single Tertiary Centre Experience from India.
Abstract
Chronic lymphocytic leukemia (CLL) is
the commonest leukemia in the western
population. There is limited data on CLL
from the Indian subcontinent. We undertook
a descriptive retrospective study of
all cases of CLL presenting at our centre
over the last 5 years. 125 cases of CLL
were diagnosed in this period. The median
age was 60 years (range 34-85). 42
(33.6) patients were 55 years (young
CLL). The male to female ratio was 31.
At presentation, 52 were incidentally detected,
29 had lymphadenopathy, 5 had
transfusion dependent anaemia and 1.6
had fever. Hepatomegaly, splenomegaly,
anaemia and thrombocytopenia were
seen in 47.2, 40.8, 46.4 and 20.8 respectively.
The median WBC and absolute
lymphocyte count at diagnosis was 40 x
10 9Lt (range 6.8 to 528) and 33 x 10 9Lt
(range 4.2 to 512), respectively. Majority
of patients presented in Rai stage stage
III (25.6) and IV (27.2). CD 38 positivity
on flowcytometry was seen in 36.8 of
cases, with no difference in the clinical
and laboratory parameters
between CD 38 positive and negative patients
at presentation. 69 patients received
treatment. Of these, 17 achieved a partial
remission and 7 achieved complete remission.
While the overall clinical presentation
was similar to data reported internationally
in our series we found a more advanced
stage of disease at presentation, a lower
median age at diagnosis, a larger young
CLL population and a higher incidence of
splenomegaly in the young CLL. Chlorambucil
and cyclophosphamide continues to
be used widely as a therapeutic option.
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