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Presenting features and prognosis of chronic lymphocytic leukemia in
younger adults [see comments]
E Montserrat, F Gomis, T Vallespi, A Rios, A Romero, J Soler, A Alcala, M Morey, C Ferran and J Diaz-Mediavilla
Spanish Cooperative Group for CLL Study, Postgraduate School of Hematology,
Farreras Valenti, Hospital Clinic, University of Barcelona, Spain.
We have analyzed 117 younger patients with chronic lymphocytic leukemia
(CLL) (mean age, 44.5 years; SD, 4.8; range, 19 to 49; male/female ratio,
2.08) with three main objectives: (1) to see whether these patients have
distinctive presenting clinical features; (2) to investigate the impact of
the disease on survival; and (3) to analyze whether already well-known
prognostic factors are also useful when applied to these patients. As
compared with an older age population (greater than or equal to 50 years),
there were no major differences in presenting features except for an
increased proportion of males (2.08 v 1.21; P less than .025) and a higher
hemoglobin level (13.47 +/- 2.70 g/dL v 12.84 +/- 2.77 g/dL; P less than
.05) in the younger group. Median survival is 12.3 years (expected median
from a control group, 31.2 years). Clinical stages, bone marrow patterns,
blood lymphocyte counts, and its doubling time are all useful to separate
different risk groups of patients. Whereas patients with favorable
prognostic factors have a survival probability of about 80% 14 years after
diagnosis, those with poor prognostic features have a median survival of
less than 3 years. It is concluded that CLL in younger adults has no major
distinctive presenting features and that known prognostic factors are
useful to separate different risk groups of patients. These results should
be of help in planning therapy for younger persons with CLL.
Volume 78,
Issue 6,
pp. 1545-1551,
09/15/1991
Copyright © 1991 by The American Society of Hematology
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