Clinical Analysis Of 47 Patient With Chronic Lymphocytic Leukemia

Objective: The clinical data of 47 patients with chronic lymphocytic leukemia(CLL)were retrospectively analyzed?The factors that influence the prognosis of the disease were explored,and the correlation between prognostic factors and risk stratification of Fluorescence in situ hybridization was analyzed?Method: The clinical data of 47 patients with CLL diagnosed at the Department of Hematology of the First Hospital of Lanzhou University from January 1,2011 to January 31,2018 were collected to analyze the risk factors affecting the patient's prognosis(sex,age,splenomegaly,leukocyte count,hemoglobin,platelet count,lactate dehydrogenase,bone marrow cell morphology,immunophenotyping,ZAP-70 and IgVH)?The risk stratification was performed according to the results of FISH test?The correlation between prognostic factors and FISH risk stratification was analyzed.Result:1.In the 47 CLL patients,32 were males and 15 were females,The ratio of male to famale was 2.13:1;the youngest was 44 years old,the oldest was 84 years old,the median age was 64 years old;the shortest survival period was 1 month,the longest survival was 83 month,,the median follow-up time was 27 months;lactate dehydrogenase ? 240U/L accounted for 31.9%(15/47);CD38 positive accounted for 23.4%(11/47);ZAP-70 expression accounted for 14.9%(7/47)IgVH mutation accounted for 83%(39/47);Binet stage:A phase accounted for 63.8%(30/47),B+C phase accounted for 36.2%(17/47);Rai phase: phase III+IV accounted for 14.9%(7/47)?2.The 5-year overall survival rate of whom with high level of LDH,CD38 positive,high ZAP-70 expression,later Binet stage and Rai stage was lower?The 5-year overall survival rate of whom with IgVH mutation was higher?3.Cytogenetic abnormalities was about78.7%(37/47)according to the FISH result,of which D13S25 deletion accounted for 44.6%(21/47),RB1 deletion accounted for 39.2%(18/47),and P53 deletion accounted for 27.4%(13/47)The abnormality of CSP12 accounted for 25.5%(12/47)and ATM loss accounted for 10.6%(5/42)?At the same time,two or more molecular genetic abnormalities accounted for 46.8%(22/47)?4.Correlation analysis between prognostic factors and FISH risk stratification revealed that only the Binet stage(B stage and C stage)was associated with genetic risk stratification?Conclusion:1.CLL often occured in older men,with Binet Phase A as the initial diagnosis?2.High LDH,CD38 positive,IgVH non-mutation,ZAP-70 expression,clinical stage(Binet B and C,Rai III and IV)were all adverse factors which will affect the prognosis of CLL?3.Binet staging was positively correlated with the risk stratification of cytogenetics?...