Impact of clinical staging and demographic data (age and sex) on response to treatment and survival of chronic lymphocytic leukemia patients in Kurdistan Region of Iraq
Bryar Sabah Rashid1, Sana D Jalal2, Ahmed K Yassin3, Kawa M Hassan3, Zeki A Mohamed4, Zhala O Ahmed1, Tavan I Mahmood1, Rawand P Shamoon5, Shokhan M Mustafa6, Marwa Nadhim Karam6, Dana A Abdullah2, Shlan S Mohammad6, Lara L Abdulrahman6, Rozh-hat A Yousif7, Basil K Abdulla1, Nawsherwan S Mohammed5, Hisham A Getta8, Ranan K Polus5, Ghanim S Numan6
1 Department of Hematology, Hiwa Cancer Hospital, Sulaymaniyah, Iraq
2 Department of Pathology, College of Medicine, University of Sulaimani, Sulaymaniyah, Iraq
3 Department of Medicine, College of Medicine, Hawler Medical University, Erbil, Iraq
4 Department of Medicine, College of Medicine, University of Duhok, Duhok, Kurdistan Region, w, Duhok
5 Department of Pathology, College of Medicine, Hawler Medical University, Erbil, Iraq
6 Department of Hematology, Nanakali Hospital, Erbil, Iraq
7 Department of Hematology, Azadi Hospital, Duhok, Kurdistan Region, Iraq
8 Department of Pathology, College of Medicine, University of Sulaymaniyah, Sulaymaniyah, Iraq
Dr. Bryar Sabah Rashid
Department of Hematology, Hiwa Cancer hospital, Sulaymaniyah, Kurdistan Region
Source of Support: None, Conflict of Interest: None
BACKGROUND: The clinical course of patients with chronic lymphocytic leukemia (CLL) is heterogeneous. Certain patients go through a brisk illness progression, and others stay alive for quite a long time without requiring treatment.
OBJECTIVE: This study was conducted to evaluate the impact of clinical staging, age, gender, and treatment initiation on the survival of CLL patients in Kurdistan-Iraq.
MATERIALS AND METHODS: A total of 239 CLL patients from Oncology Centers from Kurdistan-Iraq were enrolled in a retrospective study from January 1, 2010, to December 31, 2020. A standardized questionnaire was used to obtain demographics data, presenting features, blood investigations, and imaging results. The diagnosis and treatment assessment was based on the International Workshop of CLL, and clinical staging was performed using both Rai and Binet classifications. There were two groups of patients (watch and wait) and (treated) groups.
RESULTS: The median age at the diagnosis was 64 years old with a male: female ratio of 2.3:1. Eighty-three patients (34.7%) were diagnosed incidentally and about one-third of the patients presented with advanced stage, and also, 62.3% of the patients received therapy throughout the study period. The 3-year overall survival was (81.1%) (95% confidence interval 74.3%–87.9%). Of particular interest to report that advanced age, Binet Stage C, and hemoglobin <10 g/dl have adversly impacted the outcome.
CONCLUSION: Despite the study limitations, the resulted CLL outcome approximates the Western countries reported figures.