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Abstract

ABSTRACT: BACKGROUND: Chronic lymphocytic leukemia(CLL) is heterogeneous in its clinical course and typically diagnosed when patients presented with symptoms of lymphadenopathy, cytopenia ,constitutional symptoms or infection. Now 50% of patients with CLL are likely to be diagnosed when an elevated lymphocyte count is discovered incidentally . OBJECTIVE: Description of various presentation in adult patients with CLL, complications that happened during the course of their disease, cause of death and overall survival in these patients. PATIENTS AND METHODS: Sixty Iraqi adult patients with CLL were studied retrospectively and prospectively. These patients were assessed clinically and stratified with Rai staging, with follow up for any complications that occurred during their course of disease from time of diagnoses till last visit or death. RESULTS: In this study, the age group more than fifty years form 50(83.3%) patients and those less than fifty form 10(16.6%) patients. The commonest clinical feature reported was constitutional symptoms in 19(31.6%)patient. Rai staging of these patients found to be that most of patients intermediate stage II 22(36%) and advanced stage III, IV in 34(56.6%) Regular follow up of these patients revealed that autoimmune disorder occur in 6(10%) patients, in form of autoimmune hemolytic anemia (AIHA),pure red cell aplasia (PRCA)and immune thrmbocytopenia (ITP).The increase susceptibility to infection by different viral , bacterial and parasitic infection was noticed in these patients during their course of illness. Death in these patients was due to infection with HBV and liver failure in 2(3%)patients, obstructive jaundice and hepatic encephalopathy in one(1.6%)patients, sepsis in 4(6.6%), bleeding in one (2.04%) ,renal failure in two patients (1.6%),chronic sinusitis with fungal infection and renal failure in one (1.6%)patient ,Richeters transformation and disease progression in 7(11.6%) or due to co morbid illness (stroke, ischemic heart disease, heart failure ) in 3(5%) patients. The overall survival for these patients within five years was 50% . CONCLUSION : Constitutional symptoms was the commonest presentation of CLL Iraqi patients. The indolent course of the disease in CLL patients, still can be interrupted by different complications including infection, autoimmune disorder, and malignancy.

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