Abstract

INTRODUCTION

Infections are the leading cause of morbidity and mortality in chronic lymphocytic leukemia (CLL) patients. We aim to summarize the main clinical and biological features of CLL patients diagnosed in our center and infections occurred during their disease.

METHODS

Patients diagnosed with CLL in Numune Training and Research Hospital between January 2000 and May 2019, were retrospectively analyzed.

RESULTS

A total of 324 patients, of whom 204 were male and 120 females, were included. The median age was 64 years (33-91 years). During the follow-up, 42.9% (n = 139) were treated with a chemotherapy/immunotherapy and 17.2% (n=57) of these relapsed after the first line. Patients were analyzed according to Rai stage at diagnosis and were divided into two groups, as stage 0-2 and stage 3-4. Stage 0-2 group involved 82,4% (n=267) and stage 3-4 group 17,6% (n=57) of the patients. Acute and chronic bacterial infections were more frequent among patients with stage 3-4 disease (50.6% vs 26.6% and 7.0% vs 0%, respectively, p<0.001). CTC-AE grade 4-5 infections were higher in the stage 3-4 group (p<0.001). Hypogammaglobulinemia and the requirement of intravenous immunoglobulin (IVIg) therapy were more common in grade 3-4 group (45.6% vs 18.5% and 24.6% vs 9.7%, respectively; p<0,001 and p=0,002). Immune thrombocytopenia was also more frequent in the stage 3-4 group (5.3% vs 0.7%, p=0.03). Estimated median overall survival (OS) was 97.6+11.8 (%95 CI 74.4-120.8) months. The median follow-up time was 25.8 months (1-226.4 months). OS was significantly lower in the stage 3-4 group (P<0.001).

DISCUSSION AND CONCLUSION

Although, the distribution of type and severity of infections are stage dependent in patients with CLL, frequent infections may occur at every stage of the disease.