Pektaş Gökhan, Gönül Ercan, Öncü Şeyma, Becit Kızılkaya Merve, Sadi Gökhan, Pektaş Mehmet Bilgehan
Division of Hematology, Faculty of Medicine, Muğla Sıtkı Koçman University, 48000 Muğla, Türkiye.
Department of Medical Pharmacology, Faculty of Medicine, Afyonkarahisar Health Sciences University, 03200 Afyonkarahisar, Türkiye.
Diagnostics (Basel). 2025 Mar 14;15(6):728. doi: 10.3390/diagnostics15060728.
Understanding the pathogenesis of chronic lymphocytic leukemia (CLL) has led to the development of new prognostic and diagnostic tools, and efforts are underway to extend survival with new prognostic markers and treatment agents. This study aims to evaluate the factors affecting the prognosis and survival of patients with CLL via a retrospective study. Accordingly, the demographic features of, clinical and laboratory findings for, and hematological parameters and treatment responses of 178 CLL patients who were followed between 1 January 2015 and 31 December 2024 were analyzed before and after treatment protocols were carried out. During the follow-up period, 40.8% of the patients received medical therapy, with 42.5% achieving complete remission, 49.3% experiencing partial remission, and 8.2% demonstrating no response to the treatments. The results demonstrated that an advanced Binet stage, the presence of splenomegaly, a positive direct Coombs test, the presence of a 17p deletion, thrombocytopenia, and elevated creatinine, leukocyte, and lymphocyte counts were associated with increased mortality. Elevated Binet and Rai stages, the existence of 17p deletion, and reduced hemoglobin levels were identified as statistically significant factors. Given the unfavorable prognosis of CLL patients exhibiting a positive direct Coombs test and compromised renal function, further investigations are required to validate the necessity of more rigorous monitoring and, possibly, early intervention. These findings underscore the importance of identifying high-risk factors in CLL to optimize patient management and improve long-term outcomes.
对慢性淋巴细胞白血病(CLL)发病机制的理解推动了新的预后和诊断工具的发展,目前正在努力通过新的预后标志物和治疗药物来延长生存期。本研究旨在通过一项回顾性研究评估影响CLL患者预后和生存的因素。因此,对2015年1月1日至2024年12月31日期间随访的178例CLL患者在实施治疗方案前后的人口统计学特征、临床和实验室检查结果、血液学参数及治疗反应进行了分析。在随访期间,40.8%的患者接受了药物治疗,其中42.5%达到完全缓解,49.3%部分缓解,8.2%对治疗无反应。结果表明,Binet分期晚期、脾肿大、直接抗人球蛋白试验阳性、存在17p缺失、血小板减少以及肌酐、白细胞和淋巴细胞计数升高与死亡率增加相关。Binet和Rai分期升高、存在17p缺失以及血红蛋白水平降低被确定为具有统计学意义的因素。鉴于直接抗人球蛋白试验阳性且肾功能受损的CLL患者预后不良,需要进一步研究以验证更严格监测以及可能的早期干预的必要性。这些发现强调了识别CLL高危因素对于优化患者管理和改善长期结局的重要性。