The pattern of bone marrow involvement among chronic lymphocytic leukemia patients and its impact on the disease outcome in Kurdistan Region of Iraq
Marwa Nadhim Karam1, Kawa M Hasan2, Nawsherwan S Mohammed3, Ahmed K Yassin2, Shokhan Mohammad Mustafa1, Lara Lateef Abdulrahman1, Ranan K Polis4, Ghanim S Numan1, Shlan S Mohammed1, Rawand P Shamoon3, Bryar Sabah Rashid4, Sana D Jalal5, Rozhhat A Yousif6, Zeki A Mohamed7, Tavan I Mahmood4, Basil K Abdulla8, Dana A Abdullah5, Zhalla O Ahmed14, Hisham A Getta5
1 Department of Clinical Hematology, Nanakaly Hospital for Blood Disease, Erbil, Iraq
2 Department of Clinical Hematology, Nanakaly Hospital for Blood Disease; Department of Medicine, College of Medicine, Hawler Medical University, Erbil, Iraq
3 Department of Pathology and Medicine, College of Medicine, Hawler Medical University, Erbil, Kurdistan Region, Iraq
4 Department of Clinical Hematology, Hiwa Hospital for Blood Disease, Sulaymaniyah, Kurdistan Region, Iraq
5 Department of Pathology, College of Medicine, University of Sulaymaniyah, Sulaymaniyah, Kurdistan Region, Iraq
6 Azadi Centre for Blood Disease, Duhok, Kurdistan Region, Iraq
7 Department of Medicine, College of Medicine, University of Duhok, Duhok, Kurdistan Region, Iraq
8 Department of Hematology, Hiwa Cancer hospital, Sulaymaniyah, Kurdistan Region, Iraq
Dr. Marwa Nadhim Karam
Nanakaly Hospital for Blood Disease, Erbil, Kurdistan Region
Source of Support: None, Conflict of Interest: None
OBJECTIVES : There are the variable degrees of bone marrow (BM) infiltration patterns in chronic lymphocytic leukemia (CLL). Four BM patterns: Interstitial, nodular, mixed, and diffuse patterns were identified. The aim of this study is to assess the effects of BM infiltration patterns on the disease outcome among CLL patients in Kurdistan Region of Iraq.
METHODS: This study is a cross-sectional, descriptive, retrospective involved 106 patients with CLL disease. The data are collected in the Kurdistan region of Iraq (including Erbil, Sulaymaniyah, and Duhok) cancer centers. Through the period from January 1, 2010 to December 31, 2019. BM histopathology study of all patients was assessed and correlated with the disease outcome.
RESULTS: Fifty-three (50.0%) patients had interstitial BM patterns, 17 (16.0%) had nodular BM pattern, 14 (13.2%) had mixed BM patterns, and 22 (20.8%) had diffuse BM pattern. The results showed that patients with interstitial, nodular, and mixed BM patterns had a superior overall survival (OS) and progression-free survival (PFS) rate than diffuse BM pattern. Kaplan–Meier curve illustrates that our CLL patients with interstitial BM patterns had a better mean OS rate (44.0 months) than diffuse BM pattern with a mean of (23.2 months). As well as for PFS, the mean was (35.7 months) for the interstitial BM patterns and (17.6 months) for diffuse BM pattern.
CONCLUSIONS: We demonstrate that the BM involvement patterns have a prognostic value in our CLL patients and provide more reliable information regarding the clinical outcome.