Clinico-Hematological profile and treatment outcome of chronic lymphocytic leukemia: A single center study from Pakistan.

Abstract

Objective: To evaluate clinical, hematological characteristics and treatment outcome of CLL patients in Pakistan. Study Design: Prospective Cross Sectional study. Setting: National Institute of Blood Diseases and Bone Marrow Transplantation (NIBD), Karachi, Pakistan. Period: January 2023 to November 2024. Methods: A total of 86 patients were included. The data was analyzed by using SPSS version 23.0. Comparative analysis was performed by using the log-rank test. The p-value of 0.05 was considered statistically significant. Overall survival was calculated by using the Kaplan-Meier method. Results: The study included 86 CLL patients with a median age of 59 years (IQR: 50-65 years). The male-to-female ratio was 1.86:1. Twenty-five (29.06%) patients were asymptomatic, while fatigue was the most common symptom observed in 40(46.9%) patients. Lymphadenopathy was seen in 60 (69.8%) patients with elder predominance (p = 0.038). Forty-five (52.3%) patients had anemia however, thrombocytopenia was observed in 18(20.9%) patients. Twenty-eight (32.5%) patients presented at higher-risk rai stage. A total of 61(70.9%) patients required treatment with a median interval of 4 months after diagnosis. Chlorambucil (47.4%) and ibrutinib (37.70%) were the most common regimens administered. The overall survival rate was higher in age group <55 years (74%) as compared to the elder group which was 47%. (p-value 0.072). Conclusion: Our study revealed that CLL in Pakistan mainly affects older adults, particularly male as seen in the western world. However, the clinical and hematological characteristics of our patients differ from existing literature. Further multicenter studies with larger sample size and prognostic biomarkers are needed to enhance risk stratification and treatment efficacy.