ANALYSIS OF PROGNOSTIC FACTORS AND TIME TO FIRST TREATMENT IN YOUNG PATIENTS (<55 YEARS) WITH CHRONIC LYMPHOCYTIC LEUKEMIA: A SINGLE CENTER EXPERIENCE

Chronic Lymphocytic Leukemia (CLL) is the most common leukemia among elderly people in the western world. Younger CLL patients (≤55 years) account for only 10% to 15% of the CLL population. Clinical characteristics and outcomes of Younger CLL patients are a matter of debate; a better knowledge is a crucial objective to identify patients with different prognostic features. In our study we investigated clinical characteristics and time to first treatment of younger patients with CLL treated at our Institution. We retrospectively evaluated patients (pts) with de novo CLL treated at the University Hospital of Bari (Italy) between April 2006 and February 2017.At diagnosis pts were studied for clinical characteristics and biological prognostic factors: age, -2 microglobulin, absolute lymphocyte count, sex, Rai stage, number of involved lymph node groups, pattern of bone marrow involvement, splenomegaly, mutational status of the immunoglobulin heavy chain gene variable region (IGVH). Patients were divided into two groups according to age: younger CLL pts (≤55 years) and older CLL pts (&gt;55 years). Cytogenetic abnormalities at diagnosis were detected by FISH in 20 pts in the younger group and 35 pts in the older group. Time to first treatment (TFT) was measured as the time elapsed between diagnosis and first treatment.Patients were divided in two groups according to age. The first group included younger CLL pts (≤55 years); the second group included older CLL pts (&gt;55 years). Univariate analyses were performed in each group to evaluate the correlation between age and clinical variables at diagnosis. TTF was also calculated and compared in the two groups. In total 75 pts were included; 24 pts under 55 years at diagnosis and 51 older pts at diagnosis. Statistically significant differences were seen between the 2 groups regarding absolute lymphocyte count (&lt;50,000 versus &gt;50,000 P&lt;.001), -2 microglobulin (normal versus elevated; P=.009); splenomegaly (present versus absent; P=.035), cytogenetic abnormalities by FISH (P&gt;.001), all significantly more common among older patients. By contrast, no statistically significant difference between the 2 groups was seen for TTF (P:0.139). In conclusion, although adverse prognostic markers were less common in our study among younger patients at diagnosis, the time to progression of younger pts in terms of TFT was similar to that in the older population. Multicentric studies and larger cohorts of patients are warranted to confirm these data.