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1/2025
vol. 29
abstract:
Original paper
Accelerated chronic lymphocytic leukemia – characteristics and retrospective analysis of the Polish Adult Leukemia Study Group
Elżbieta Iskierka-Jażdżewska
2, 3
,
Joanna Drozd-Sokołowska
6
,
Ewa Paszkiewicz-Kozik
11
,
Ewa Wąsik-Szczepanek
12
,
Anna Szumera-Ciećkiewicz
15, 16
,
Monika Prochorec-Sobieszek
17
,
Dorota Jesionek-Kupnicka
18
,
- Department of Hematology, Institute of Hematology and Transfusion Medicine, Warszawa, Poland
- Department of General Hematology, Copernicus Memorial Hospital in Łódź, Medical University, Łódź, Poland
- Department of Hematology, Medical University, Łódź, Poland
- Department of Hematooncology, Copernicus Memorial Hospital, Łódź, Poland
- Section of Hematology/Oncology, University of Chicago, Chicago, IL, USA
- Department of Hematology, Transplantation and Internal Medicine, Medical University, Warszawa, Poland
- Hematology Department, St John’s Cancer Centre, Lublin, Poland
- Department of Hematology, Institute of Medical Sciences, University of Opole, Opole, Poland
- Department of Hematology and Transplantology, Medical University, Gdańsk, Poland
- Department of Internal Diseases and Oncological Chemotherapy, Faculty of Medical Sciences, Medical University of Silesia, Katowice, Poland
- Department of Lymphoid Malignancies, Maria Skłodowska-Curie National Research Institute of Oncology, Warszawa, Poland
- Department of Hematooncology and Bone Marrow Transplantation, Medical University, Lublin, Poland
- Hematology Department, Institute of Medical Sciences, College of Medical Sciences, University, Rzeszów, Poland
- Department of Hematology, Provincial Hospital, Szczecin, Poland
- Department of Pathology, Maria Skłodowska-Curie National Research Institute of Oncology, Warszawa, Poland
- Biobank, Maria Skłodowska-Curie National Research Institute of Oncology, Warszawa, Poland
- Diagnostic Hematology Department, Institute of Hematology and Transfusion Medicine, Warszawa, Poland
- Department of Pathology, Chair of Oncology, Medical University, Łódź, Poland
- Department of Pathomorphology, University Clinical Centre, Medical University, Warszawa, Poland
Contemp Oncol (Pozn) 2025; 29 (1): 28–35
Online publish date: 2025/04/09
PlumX metrics:
Introduction:
Accelerated chronic lymphocytic leukemia (A-CLL) is a rare histological variant of CLL, which is associated with an aggressive clinical presentation and worse prognosis. The aim was to study the characteristics and treatment outcomes of A-CLL patients.
Material and methods:
The retrospective analysis included 106 A-CLL patients treated in Poland between 2013 and 2023.
Results:
Median overall survival (OS) for treatment-naive A-CLL was 6.05 years (95% CI: 4.7–NA) and median progression-free survival (PFS) was 5.66 years (95% CI: 4.05–6.34). Factors associated with worse PFS were: Eastern Cooperative Oncology Group > 2 (p < 0.0001) and del17p (p = 0.002). In the whole group, fludarabine-based regimens improved OS (p = 0.002) and PFS (p = 0.002). This therapy proved superior to R-CHOP-like protocols for both OS (p = 0.002) and PFS (p = 0.004). The difference in survival between fludarabine-based regimens and targeted therapy was not significant. However, the group of patients treated with new therapies was very heterogeneous. Fludarabine (p = 0.004) or targeted therapy (p = 0.02) in any line of treatment during acceleration was associated with a reduced risk of death.
Conclusions:
This study represents one of the largest datasets of A-CLL patients and shows its poorer prognosis compared to typical CLL. Chronic lymphocytic leukemia directed therapy should be considered as a treatment modality of choice for A-CLL. R-CHOP protocols are less effective.
keywords:
acceleration, chronic lymphocytic leukemia, Richter transformation
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