Chronic lymphocytic leukemia (CLL) in younger adults: A retrospective study of 133 cases

Abstract

Clinical and biological data have been evaluated, using both univariate and Cox's multivariate statistical analyses, in a series of 133 Chronic Lymphocytic Leukemia (CLL) patients with a mean age of 46.6 years (range 31-50). In univariate analyses, anemia (Hb less than 13 g/dl), peripheral blood (PB) lymphocytosis (greater than 40 x 10(9)/l) and bone marrow (BM) lymphocytosis (greater than 80 per cent) were shown to be of significant prognostic value. Multivariate analysis, through a forward stepwise procedure, showed that the most important and independent variable is the BM lymphocytosis. These results are different from those obtained in previous studies and particularly in a recent identical study performed by the same Cooperative Group on 1777 patients with a mean age of 64.2 years (Mandelli et al., 1987). No significance can be demonstrated in stratifying this series of younger patients according to different staging methods (Rai et al., 1975; Binet et al., 1981b; Mandelli et al., 1987). Therefore this population of CLL patients, with less than 50 years of age, has risk factors quite different from classical CLL. The results of the present study show that the diagnostic approach to B-CLL in younger adults must be more complete: using the common diagnostic criteria, established staging systems appear to be inadequate in this series of younger patients.

Comparison of younger versus older B‐cell chronic lymphocytic leukemia patients for clinical presentation and prognosis. A retrospective study of 53 cases

“…Indeed, what emerges from the present study is that distribution of clinical stages, BM histological pattern, leukocyte count, LDT value were not different between the two groups. The comparison between different series of young CLL patients and our own data shows that stage distribution is rather similar, despite the wide range of overall median survivals (15)(16)(17)(18)(23)(24)(25) (Table 4). Such a finding is not surprising if we consider that immunological criteria at diagnosis were not uniform.…”

“…However, all these studies have been carried out in series that included mostly elderly CLL patients with a median age over 60 yr. Whether prognostic factors identified in the overall CLL population also apply to younger cases, generally accounting for 10% of cases, has been In 1991, Montserrat et al (18) reported the results of the Spanish Cooperative Group which included 117 patients younger than 50 yr with welldocumented CLL and demonstrated that presenting features were not different from those of the older matter of debate (15)(16)(17). cases.…”

Chronic lymphocytic leukemia in young (<= 55 years) patients: a comprehensive analysis of prognostic factors and outcomes

“…<200 patients) and are more than two decades old. 6,[8][9][10][11] The most recent and largest series was reported in 1999 and included 204 patients. 7 The past decade has been a time of tremendous change in the clinical care of patients with CLL.…”

“…[22][23][24][25] Due to these profound changes, data from historical reports on clinical outcomes of younger patients with CLL are of uncertain relevance in the modern era. 6,[8][9][10][11] In the present study, we aim to describe the clinical characteristics, time to first treatment and overall survival of CLL patients ≤55 years old in the current era.…”

Chronic lymphocytic leukemia: A retrospective study of 122 cases

“…An important factor distinguishing this material from most other reports of CLL is the high median age of 71 yr, compared to 54 yr, for the early stages in Rai's original study (1). De Rossi has shown that the staging systems did not give the same prognostic information for young CLL patients as for older ones, but other studies have shown the opposite result (21,22,23). The high mean age probably plays a minor role concerning the lack of prognostic information from staging in our study.…”