Abstract

ABSTRACT:
BACKGROUND:
Chronic lymphocytic leukemia(CLL) is heterogeneous in its clinical course and typically
diagnosed when patients presented with symptoms of lymphadenopathy, cytopenia ,constitutional
symptoms or infection. Now 50% of patients with CLL are likely to be diagnosed when an elevated
lymphocyte count is discovered incidentally .
OBJECTIVE:
Description of various presentation in adult patients with CLL, complications that happened
during the course of their disease, cause of death and overall survival in these patients.
PATIENTS AND METHODS:
Sixty Iraqi adult patients with CLL were studied retrospectively and prospectively. These patients
were assessed clinically and stratified with Rai staging, with follow up for any complications that
occurred during their course of disease from time of diagnoses till last visit or death.
RESULTS:
In this study, the age group more than fifty years form 50(83.3%) patients and those less than fifty
form 10(16.6%) patients. The commonest clinical feature reported was constitutional symptoms in
19(31.6%)patient. Rai staging of these patients found to be that most of patients intermediate stage
II 22(36%) and advanced stage III, IV in 34(56.6%)
Regular follow up of these patients revealed that autoimmune disorder occur in 6(10%) patients, in
form of autoimmune hemolytic anemia (AIHA),pure red cell aplasia (PRCA)and immune
thrmbocytopenia (ITP).The increase susceptibility to infection by different viral , bacterial and
parasitic infection was noticed in these patients during their course of illness. Death in these
patients was due to infection with HBV and liver failure in 2(3%)patients, obstructive jaundice and
hepatic encephalopathy in one(1.6%)patients, sepsis in 4(6.6%), bleeding in one (2.04%) ,renal
failure in two patients (1.6%),chronic sinusitis with fungal infection and renal failure in one
(1.6%)patient ,Richeters transformation and disease progression in 7(11.6%) or due to co morbid
illness (stroke, ischemic heart disease, heart failure ) in 3(5%) patients. The overall survival for
these patients within five years was 50% .
CONCLUSION :
Constitutional symptoms was the commonest presentation of CLL Iraqi patients. The indolent
course of the disease in CLL patients, still can be interrupted by different complications including
infection, autoimmune disorder, and malignancy.