Clinical and Biological Features of Chronic Lymphocytic Leukemia A Single Tertiary Centre Experience from India

Chronic lymphocytic leukemia (CLL) is the commonest leukemia in the western population. There is limited data on CLL from the Indian subcontinent. We undertook a descriptive retrospective study of all cases of CLL presenting at our centre over the last 5 years. 125 cases of CLL were diagnosed in this period. The median age was 60 years (range 34-85). 42 (33.6) patients were 55 years (young CLL). The male to female ratio was 31. At presentation, 52 were incidentally detected, 29 had lymphadenopathy, 5 had transfusion dependent anaemia and 1.6 had fever. Hepatomegaly, splenomegaly, anaemia and thrombocytopenia were seen in 47.2, 40.8, 46.4 and 20.8 respectively. The median WBC and absolute lymphocyte count at diagnosis was 40 x 10 9Lt (range 6.8 to 528) and 33 x 10 9Lt (range 4.2 to 512), respectively. Majority of patients presented in Rai stage stage III (25.6) and IV (27.2). CD 38 positivity on flowcytometry was seen in 36.8 of cases, with no difference in the clinical and laboratory parameters between CD 38 positive and negative patients at presentation. 69 patients received treatment. Of these, 17 achieved a partial remission and 7 achieved complete remission. While the overall clinical presentation was similar to data reported internationally in our series we found a more advanced stage of disease at presentation, a lower median age at diagnosis, a larger young CLL population and a higher incidence of splenomegaly in the young CLL. Chlorambucil and cyclophosphamide continues to be used widely as a therapeutic option.