Ethnical and Clinical Aspects of Chronic Lymphocytic Leukemia in Israel

Abstract

The ethnic distribution of 288 patients with chronic lymphocytic leukemia (CLL) from five medical centers in Israel during the decade 1960–1970 was investigated as well as other features of the disease. 80.5% of the patients were of East European descent, 14.5% originated from Asia and Africa and 5% were born in Israel. Based on the ethnic distribution of the elderly population of Israel during the above period, it is suggested that CLL occurs more frequently in European-born Jews than in Asian and African Jews. A low occurrence of Coombs positive hemolytic anemia was revealed, amounting to 7.2% of the patients. Of 68 patients who underwent serum immunoglobulin studies, up to 74% exhibited deficiency of at least one type of immunoglobulin. Low levels of IgA were encountered in 61.2%, IgM in 51.5% and IgG in 29.5% of the patients. 26 of 206 patients with CLL (12.5%), all of East European origin, had an additional primary malignant tumor, cancer of the skin and breast being the most frequent associated malignancies. In 6 patients of the 26, two additional neoplasms were diagnosed. Hypogammaglobulinemia was more frequent in patients with additional primary malignant tumors and in patients with advanced disease. The possible causes for the ethnic distribution of CLL in Israel as well as of other tumors are discussed.

Epidemiology and ethnic aspects of B cell chronic lymphocytic leukemia in Israel

“…A high incidence of CLL in Israel and a striking prevalence of CLL in Jews born in European-American countries (Ashkenazi Jews) in comparison to those originating from Asia and Africa (Sephardic Jews) has been reported previously. 12,19 This present study confirms the prevalence of CLL in Jews born in Europe and America. The majority of our CLL patients originated from Eastern Europeformer USSR, Poland, Romania.…”

“…11 In Israel, the survey of 288 cases of CLL in 1978 has shown that 80% of these individuals originated from the European countries (Ashkenazi Jews), whereas only 15% descended from Asia and Africa (Sephardic Jews). 12 The impact of ethnic origin of the patients on the pattern and prog-nosis of CLL is unknown. Our present study deals with a series of 302 B cell CLL and prolymphocytic leukemia (PLL) cases, originating from Eastern Europe, Asia and Africa, followed for up to 20 years in a Southern area of Israel.…”

Chronic lymphoid leukaemia: clinico‐haematological correlation and outcome in a single institution in Niger Delta region of Nigeria

“…The elderly occurrence of CLL was reinforced in this study, as the median age was 56 years with predominant peak in the age bracket, 56–60 years. That CLL with other B‐cell lymphoproliferative disorder is frequent in males has been reported (Bartal et al. , 1978; Hoffbrand et al.…”

“…This disparity has been attributed to a higher incidence of psychosomatism and a higher tendency to seek medical attention amongst females. A survey carried out in Israel over 2 decades ago showed a similar female dominance in patients of Africa descent unlike their European counterparts, which had a male dominance (Bartal et al. , 1978).…”

Rectal cancer associated with chronic lymphocytic leukemia

“…Though we did not examine cellular immunity, concurrent hypogammaglobulinemia in our patient may have caused dysfunction of T cells and NK cells, and this, in turn, could have been associated with the development of the cancer. It has been demonstrated that CLL patients with an additional malignancy more often show low immunoglobulin levels than those patients without it, 20 and that T-cell abnormality is more prominent in CLL patients with hypogammaglobulinemia. 21 As the present patient showed an aggressive course of rectal cancer, the defective immunity may also have been associated with the rapid progression of the second malignancy.…”