Blood Res.  2018 Dec;53(4):276-280. 10.5045/br.2018.53.4.276.

Clinicohematological parameters and outcomes in a cohort of chronic lymphocytic leukemia patients with Deletion 17p from Pakistan

• Mahmood R
• Khan SA
• Altaf C
• Malik HS
• Khadim MT

• KMID: 2429300
• DOI: http://doi.org/10.5045/br.2018.53.4.276

Abstract

BACKGROUND
Chronic lymphocytic leukemia (CLL) exhibits profound heterogeneity in its clinical course. Its clinicohematological and cytogenetic features play a significant role in determining the clinical course and in predicting the treatment response and prognosis. In this context, 17p deletion is known to predict a poor prognosis, as these cases are refractory to conventional therapy. This study aimed to evaluate the clinicohematological characteristics, outcomes, and prognostic factors among CLL patients with and without del 17p in Pakistan.
METHODS
This prospective observational study was conducted at the Department of Haematology, Armed Forces Institute of Pathology (Rawalpindi, Pakistan) between January 2013 and December 2017. Patients were diagnosed based on the International Workshop on Chronic Lymphocytic Leukaemia IWCLL criteria, their clinicohematological parameters were recorded, and cytogenetic analyses were performed. The time from diagnosis to treatment and the 2-year overall survival rate were also evaluated.
RESULTS
We evaluated 130 CLL cases, including 24 patients (18.5%) with del 17p, who included 18 men (75%) and 6 women (25%). The median age was 68 years. Binet stage C was detected at the presentation in 16 patients (67%). Treatment was administered to 14 patients (70%) at a median interval of 11 months (range, 0-28 mo) after diagnosis. The overall response rate was 64.3%, the median event-free survival was 9 months (range, 1-23 mo), and the 2-year overall survival rate was 65%.
CONCLUSION
Del 17p is relatively common in Pakistan, and patients harboring this deletion had poor treatment response and survival outcomes.

Keyword

Chronic lymphocytic leukemia; Fluorescent in situ hybridization; Event-free survival; Overall survival

MeSH Terms

Arm
Cohort Studies*
Cytogenetic Analysis
Cytogenetics
Diagnosis
Disease-Free Survival
Education
Female
Humans
In Situ Hybridization, Fluorescence
Leukemia, Lymphocytic, Chronic, B-Cell*
Male
Observational Study
Pakistan*
Pathology
Population Characteristics
Prognosis
Prospective Studies
Survival Rate

Figure

• 

  Fig. 1 Factors associated with prolonged event-free survival. Significantly prolonged event-free survival (EFS) was associated with the absence of B symptoms (P=0.04), Binet stage A–B (P=0.03), del 17p clone size of <25% (P=0.03), and B2 microglobulin of <4 mg/L (P=0.05). No significant associations were observed for age, CD38+ status, or ZAP70+ status.

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