Clinical, Hematological and Immunophenotypic Profiles in Chronic Lymphocytic Leukemia in Kurdistan-Iraq

Abstract

Background and objectives: Chronic lymphocytic leukemia is the accumulation of morphologically mature lymphocytes in blood and lymphatic tissues. We aimed to outline the clinico-hematological and immunophenotypic patterns of patients with chronic lymphocytic leukemia in Kurdistan-Iraq. Methods: This is a retrospective cohort study on 154 patients referred to Sulaimani Public Health Lab and Nanakaly Hospital - Hawler from January 1st 2013 to December 31st 2017 and diagnosed as chronic lymphocytic leukemia. Demographic, clinical, and laboratory data were recorded. Clinical stages and immunological scoring were determined. Results: Median patient age at diagnosis was 70 years with a range of 39-82 and a male: female ratio of 1.8:1. Thirty five patients (22.7%) were diagnosed incidentally, and 85 (55.2%) had B-symptoms at presentation. Lymphadenopathy was the most common presenting feature, seen in 84 (54.6%) patients ,while splenomegaly reported in 40 ( 26%)patients and hepatomegaly in 7(4.6) patients. Forty four (28.6%) patients had anemia at diagnosis, while 150(97.3%) patients presented with leukocytosis, and 21(13.6%) patients had thrombocytopenia. Leukemic B-cells have a specific immunophenotypic profile: CD19, CD20 weak, CD22 weak, CD5 bright, CD23+, CD79bweak, FMC7 weak/-, CD200 and weak immunoglobulin light chain restriction. The applied scoring system revealed that 112 (72.7%) patients scored four and the rest scored five out of five. Moreover, sixty five (42.2%) patients presented with advanced Rai stage and 62(40.3%) patients presented with stage C Binet system. Conclusions: Patients characteristics were not distinct from those reported elsewhere, though a higher proportion of our patients presented with an advanced clinical stage