Chronic lymphocytic leukemia natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2]

Natural History, Complications and Prognosis

Natural History

The clinical course of chronic lymphocytic leukemia varies widely from patient to patient. Some patients die early because of complications, but most patients survive for 5 - 10 yrs. The course of the disease is benign initially but followed by terminal, progressive and resistant phase which lasts for 1 - 2 yrs.

Complications

• Common complications of chronic lymphocytic leukemia include:

• Richters syndrome
• Immunodeficiency
• Warm autoimmune hemolytic anemia
• intussusception
• Small intestinal bacterial contamination
• Colitis

Prognosis

• Prognosis is generally good, and the 5-year survival rate of patients with chronic lymphocytic leukemia is approximately 81.7%.
• Common prognostic factors for meningioma chronic lymphocytic leukemia patients age, tumor stage, and the presence of certain genetic mutations.
• The table below lists prognostic factors for chronic lymphocytic leukemia:

Prognostic Factor	Description
Age	Older age of diagnosis is associated with a worse prognosis.
Gender	Males are associated with a worse prognosis.
Performance status	Patient's poor performance status is associated with a worse prognosis.
Stage	Binet stages B and C or Rai stages II–IV are associated with a worse prognosis.
Lymphocyte doubling time	A rapid lymphocyte doubling time is associated with a worse prognosis
Genetic mutations	Deletion of chromosome 17 short arm is associated with a worse prognosis.
Prolymphocytes percent	An increased percentage of prolymphocytes is associated with a worse prongnosis.
Histological analysis	Diffuse histology on bone marrow aspiration is associated with a worse prognosis.
Lactate dehydrogenase (LDH) level	Elevated levels of LDH are associated with a worse prognosis.
β2-microglobulin level	Elevated levels of β2-microglobulin level are associated with a worse prognosis.
Lymphocyte surface marker	Positive expression of CD38 is associated with a worse prognosis.
Immunoglobulin (Ig)VH gene	The absence of VH gene mutation is associated with a worse prognosis.
Membrane-bound proteins	The expression of Zeta-chain-associated protein kinase 70 (ZAP) is associated with a poor prognosis.

References

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