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BACKGROUND: Chronic lymphocytic leukemia is an uncommon type of leukemia in Iraq, although many reported cases of chronic lymphocytic leukemia in the Iraqi Kurdistan region are of high risk stage. Staging of chronic lymphocytic leukemia is essential in treatment planning and for disease prognosis. the aims of this study were to find out the difference in patients' survival with early and late clinical stages, and to evaluate CLL outcome in relation to the Rai and Binet staging. PATIENTS AND METHODS: This retrospective cross-sectional analysis studied 250 patients, 170 male and 80 female, with chronic lymphocytic leukemia who were registered in three hemato-oncology centers in Iraqi Kurdistan for the last 10 years. The diagnosis of the disease was made according to the guideline of the International Workshop Chronic Lymphocytic Leukemia update of the National Cancer Institute. The patients' clinical staging was determined by a senior hematologist based on the clinical and laboratory findings. RESULTS: The mean age of the patients was 63(±11.8) years, 40% were >65 years. The median survival was 27 months. Elderly patients >65 years had significantly lower mean survival. The Rai staging was distributed as follows: stage 0 (24.8%), stage I (12.8%), stage II (30.8%), stage III (9.6%) and stage IV (22%). The median survival was significantly higher among patients with Rai stage 0 comparing to patients with advanced stages (P

OBJECTIVES : There are the variable degrees of bone marrow (BM) infiltration patterns in chronic lymphocytic leukemia (CLL). Four BM patterns: Interstitial, nodular, mixed, and diffuse patterns were identified. The aim of this study is to assess the effects of BM infiltration patterns on the disease outcome among CLL patients in Kurdistan Region of Iraq. METHODS: This study is a cross-sectional, descriptive, retrospective involved 106 patients with CLL disease. The data are collected in the Kurdistan region of Iraq (including Erbil, Sulaymaniyah, and Duhok) cancer centers. Through the period from January 1, 2010 to December 31, 2019. BM histopathology study of all patients was assessed and correlated with the disease outcome. RESULTS: Fifty-three (50.0%) patients had interstitial BM patterns, 17 (16.0%) had nodular BM pattern, 14 (13.2%) had mixed BM patterns, and 22 (20.8%) had diffuse BM pattern. The results showed that patients with interstitial, nodular, and mixed BM patterns had a superior overall survival (OS) and progression-free survival (PFS) rate than diffuse BM pattern. Kaplan–Meier curve illustrates that our CLL patients with interstitial BM patterns had a better mean OS rate (44.0 months) than diffuse BM pattern with a mean of (23.2 months). As well as for PFS, the mean was (35.7 months) for the interstitial BM patterns and (17.6 months) for diffuse BM pattern. CONCLUSIONS: We demonstrate that the BM involvement patterns have a prognostic value in our CLL patients and provide more reliable information regarding the clinical outcome.

BACKGROUND: The clinical course of patients with chronic lymphocytic leukemia (CLL) is heterogeneous. Certain patients go through a brisk illness progression, and others stay alive for quite a long time without requiring treatment. OBJECTIVE: This study was conducted to evaluate the impact of clinical staging, age, gender, and treatment initiation on the survival of CLL patients in Kurdistan-Iraq. MATERIALS AND METHODS: A total of 239 CLL patients from Oncology Centers from Kurdistan-Iraq were enrolled in a retrospective study from January 1, 2010, to December 31, 2020. A standardized questionnaire was used to obtain demographics data, presenting features, blood investigations, and imaging results. The diagnosis and treatment assessment was based on the International Workshop of CLL, and clinical staging was performed using both Rai and Binet classifications. There were two groups of patients (watch and wait) and (treated) groups. RESULTS: The median age at the diagnosis was 64 years old with a male: female ratio of 2.3:1. Eighty-three patients (34.7%) were diagnosed incidentally and about one-third of the patients presented with advanced stage, and also, 62.3% of the patients received therapy throughout the study period. The 3-year overall survival was (81.1%) (95% confidence interval 74.3%–87.9%). Of particular interest to report that advanced age, Binet Stage C, and hemoglobin

BACKGROUND: Chronic lymphocytic leukemia (CLL) is characterized by a lower incidence rate in Iraq and Kurdistan as compared to Western countries. However, a good prognosis of CLL is dependable on diagnosis, risk stratification, and a better choice of an appropriate treatment regimen. AIM OF THE STUDY: To evaluate the effectiveness of fludarabine, cyclophosphamide, and rituximab (FCR) regimen in comparison to other chemotherapy regimens in the management of patients with CLL in Kurdistan region/Iraq. PATIENTS AND METHODS: A retrospective review study carried out in three cancer centers in the Kurdistan region of Iraq for the duration of 10 years through the period from January 1, 2010 to December 31, 2019, on 152 CLL patients. CLL was diagnosed according to the International Workshop on CLL. The treatment of CLL patients was either by FCR chemo-immunotherapy regimen or other chemotherapies. RESULTS: The FCR chemo-immunotherapy was the treatment of 38.8% of CLL patients, while 61.2% of CLL patients were treated by other chemotherapies. There was a significant association between younger age patients and the use FCR chemo-immunotherapy (P = 0.001). There was a significant association between a complete response and treatment by FCR chemo-immunotherapy (P = 0.02). The mean overall survival duration and progression-free survival of CLL patients treated by FCR chemo-immunotherapy were significantly longer than the mean survival time of CLL patients treated by other chemotherapies (P = 0.01). CONCLUSIONS: Complete response and survival of CLL patients treated by FCR chemo-immunotherapy were better than the complete response and survival of CLL patients treated by other chemotherapies.