Chronic lymphocytic leukemia in Turkey: experience of a single center in Istanbul.
BACKGROUND
In this study, the clinical characteristics, survival, and prognostic factors of 200 patients diagnosed as having chronic lymphocytic leukemia (CLL) were analyzed.


METHODS
The medical charts of 200 CLL patients registered to our center between 1984 and 2000 were retrospectively evaluated.


RESULTS
Of all patients, 129 were men and 71 were women (male/female ratio, 1.82). The median age at the time of initial diagnosis was 63 years (range, 38-90 years). Sixty patients were classified as Binet's Stage A, 49 as Stage B, and 91 as Stage C. Sixty-two cases were diagnosed during routine laboratory examinations when they were asymptomatic. Forty-three patients were lost to follow-up, and 157 patients have been followed regularly until the end of the study period. Hemolytic anemia developed in nine (5.7%) patients, second primary cancer in six (3.8%), and Richter's syndrome in two (1.2%). Forty-eight percent of CLL patients were treated immediately after initial diagnosis. The overall response (complete or partial) to first-line and second-line therapies was 61.6% and 54.4%, respectively. The median time of follow-up for patients followed up regularly was 47 months (range, 1-195 months). Sixty-three patients died during the follow-up: the deaths of 39 (62%) of these were attributable to CLL-related causes. The median survival time was 48 months. The 5-year survival rate was 36.5% and the 10-year survival rate was 8%. Stage according to Rai's classification, lymphocyte count, and age showed a significant prognostic effect on survival by univariate analysis. On multivariate analysis, advanced age and lymphocyte count were independent prognostic parameters.


CONCLUSIONS
In our study, more asymptomatic CLL patients have been diagnosed in recent years. The survival, especially of our early-stage patients, was shorter than that in other CLL series of Western origin. Rai's staging system was seen to determine prognosis better than Binet's staging system.
Pamuk
Omer Nuri
ON
Division of Hematology, Department of Internal Medicine, Cerrahpaşa Medical Faculty, University of Istanbul, Istanbul, Turkey. onpamuk80@hotmail.com
Pamuk
Gülsüm Emel
GE
Soysal
Teoman
T
Ongören
Seniz
S
Başlar
Zafer
Z
Ferhanoğlu
Burhan
B
Aydin
Yildiz
Y
Ulkü
Birsen
B
Aktuğlu
Gulten
G
Akman
Nuran
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D014421:Turkey / Q000453:epidemiology