Olafsson Gunnar Bjorn, Steingrimsdottir Hlif, Vidarsson Brynjar, Halldorsdottir Anna Margret
Laeknabladid. 2016 Apr;102(4):171-7. doi: 10.17992/lbl.2016.04.74.
Chronic lymphocytic leukemia (CLL) is characterized by the proliferation of monoclonal B-lymphocytes. MBL (monoclonal B-cell lymphocytosis) is considered a precursor state of the disease. Although CLL is incurable it is an indolent disorder and often detected incidentally on routine blood counts. Until now little information has been available on CLL in Iceland, including the incidence, diagnosis, symptoms or MBL precursor state.
This is a retrospective, descriptive study including CLL patients diagnosed in Iceland over the years 2003-2013. Registries of patients with a CLL diagnosis were obtained from the Icelandic Cancer Registry, Landspitali National University Hospital and the Medical Center in Mjódd. Medical records were reviewed for information on symptoms, diagnosis and treatment. Survival data and causes of death were obtained from national registries.
The number of patients diagnosed with CLL over the study period was 161 (109 males, 52 females). The calculated incidence was 4.55/100,000, and the age-standardized incidence was 3.00/100,000. Mean age at diagnosis was 70.9 years (range 35-96 years). The Icelandic Cancer Registry lacked information on 28 patients (17.4%). The initial diagnosis of CLL was obtained exclusively with flow cytometry in 47.2% of cases. Symptoms were present at diagnosis in 67 of 151 patients (44.4%). One third of the group received chemotherapy and the average time to treatment was 1.3 years. Five-year survival was 70% and median survival was 9.4 years. Elevated lymphocyte counts (≥4,0x109/L) in peripheral blood prior (0.1 to 13.4 years) to diagnosis of CLL was identified in 85 of 99 CLL patients (85.9%).
The incidence of CLL in Iceland is similar to other Western countries. The registration of CLL cases in the Icelandic Cancer Registry must be improved, especially in cases where diagnosis is based solely on flow cytometry. Elevated lymphocyte counts were present in a large proportion of cases prior to the diagnosis of CLL.
Chronic lymphocytic leukemia, CLL, monoclonal B-cell lymphocytosis, MBL, incidence, diagnosis. Correspondence: Anna Margret Halldorsdottir, annamha@landspitali.is.
慢性淋巴细胞白血病（CLL）的特征是单克隆B淋巴细胞增殖。单克隆B细胞淋巴细胞增多症（MBL）被认为是该疾病的前驱状态。尽管CLL无法治愈，但它是一种惰性疾病，常在常规血常规检查时偶然发现。到目前为止，冰岛关于CLL的信息很少，包括发病率、诊断、症状或MBL前驱状态。
这是一项回顾性描述性研究，纳入了2003年至2013年在冰岛诊断的CLL患者。从冰岛癌症登记处、国家大学医院兰斯皮塔利医院和米奥德医疗中心获取CLL诊断患者的登记信息。查阅病历以获取症状、诊断和治疗方面的信息。生存数据和死亡原因来自国家登记处。
研究期间诊断为CLL的患者有161例（男性109例，女性52例）。计算得出的发病率为4.55/10万，年龄标准化发病率为3.00/10万。诊断时的平均年龄为70.9岁（范围35 - 96岁）。冰岛癌症登记处缺少28例患者（17.4%）的信息。47.2%的病例仅通过流式细胞术进行CLL的初始诊断。151例患者中有67例（44.4%）在诊断时有症状。该组中有三分之一接受了化疗，平均治疗时间为1.3年。五年生存率为70%，中位生存期为9.4年。99例CLL患者中有85例（85.9%）在诊断CLL之前（0.1至13.4年）外周血淋巴细胞计数升高（≥4.0x10⁹/L）。
冰岛CLL的发病率与其他西方国家相似。冰岛癌症登记处对CLL病例的登记必须改进，特别是在仅基于流式细胞术进行诊断的情况下。很大一部分CLL病例在诊断之前淋巴细胞计数升高。
慢性淋巴细胞白血病，CLL，单克隆B细胞淋巴细胞增多症，MBL，发病率，诊断。通信作者：Anna Margret Halldorsdottir，annamha@landspitali.is
