A Glance to Infectious Complications During the Course of Chronic Lymphocytic Leukemia: Single Center Experience

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.

Kronik Lenfositik Lösemi Sýrasýnda Geliþen Enfeksiyöz Komplikasyonlara Bir Bakýþ: Tek Merkez Deneyimi

GÝRÝÞ ve AMAÇ: Enfeksiyonlar kronik lenfositik lösemi (KLL) hastalarýnda mortalite ve morbiditenin en önemli sebeplerindendir. Bu çalýþmada, KLL tanýlý hastalarýmýzýn ana klinik ve biyolojik özellikleri ile birlikte hastalýðýn seyri esnasýnda geliþen enfeksiyonlarý özetlemeye çalýþtýk.
YÖNTEM ve GEREÇLER: Numune Eðitim ve Araþtýrma Hastanesinde Ocak 2000-Mayýs 2019 tarihleri arasýnda KLL tanýsý alan hastalar retrospektif olarak deðerlendirildi
BULGULAR: 204 erkek, 120 kadýn toplam 324 hasta çalýþmaya dahil edildi. Ortanca yaþ 64 (33-91 yýl) saptandý. Takip süresince, %42,9 (n = 139) hasta kemoterapi/immunoterapi ile tedavi edildi ve bu hastalarýn %17,2’ si (n=57) ilk tedaviden sonra nüks etti. Hastalar RAI evresine göre gruplandýrýldý. 267 (%82,4) hasta evre 0-2, 57 (%17,6) hasta evre 3-4 grubundaydý. Akut ve kronik bakteriyel enfeksiyonlar RAI evre 3-4 olan grupta daha sýktý (%50,6 ve %26,6, %7,0 ve %0, sýrasýyla, p<0,001). CTC-AE grade 4-5 enfeksiyon sýklýðý evre 3-4 olan grupta daha yüksekti (p<0,001). Hipogamaglobulinemi ve intravenöz immunglobulin (IVIg) tedavi ihtiyacý evre 3-4 olan grupta daha sýk görüldü (%45,6 ve %18,5, %24,6 ve %9,7, sýrasýyla; p<0,001 ve p=0,002). Immuntrombositopeni evre 3-4 olan grupta daha sýktý (%5,3 ve %0,7, p=0,03). Ortanca toplam sað kalým (OS) 97,6+11,8 ay (%95 CI 74,4-120,8) aydý. Ortanca takip süresi 25,8 ay (1-226,4 ay) saptandý. Evre 3-4 hastalýk grubunda OS anlamlý olarak kýsa bulundu (p<0,001).
TARTIÞMA ve SONUÇ: KLL hastalarýnda, enfeksiyonlarýn tipinin ve ciddiyetinin daðýlýmý evre baðýmlý olmakla birlikte, hastalýðýn her evresinde enfeksiyöz komplikasyonlar sýk görülebilir.