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

Dr. Dashne Jamal  Rasheed; Dr. Sana Dlawar  Jalal; Dr. Ahmed Kudair  Yassin

doi:10.56056/amj.2022.138

Authors

Dr. Dashne Jamal Rasheed MBChB, Senior registrar, Sulaimani Thalassemia Center
Dr. Sana Dlawar Jalal MBChB, FRCPath, Assistant professor of hematology, Department of pathology, College of Medicine, University of Sulaimani
Dr. Ahmed Kudair Yassin MBChB, FRCP, Consultant clinical hematologist, Department of Medicine, Hawler Medical University, College of Medicine

DOI:

https://doi.org/10.56056/amj.2022.138

Keywords:

Chronic lymphocytic leukemia, Staging, Flow cytometry

Abstract

Background and objectives: Chronic lymphocytic leukemia is the accumulation of morphologically mature lymphocytes in blood and lymphatic tissues. We aimed to outline the clinical-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 1^st, 2013 to December 31^st, 2017 and diagnosed with 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⁺, CD79b^weak, 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.

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