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Prognosis of Chronic Lymphocytic Leukemia

Prognosis of Chronic Lymphocytic Leukemia

The prognosis of Chronic Lymphocytic Leukemia (CLL) is rather mixed. Most patients will live for 5 to 10 years. However, some die within 2-3 years of diagnosis.

In most patients, the disease begins in a benign way followed by a progressive and resistant terminal phase that lasts for 1-2 years. During the latter phase morbidity is high, both due to the disease itself and from the complications that are caused by the therapy.

The prognosis of Chronic Lymphocytic Leukemia may be influenced by -

  • The duration of CLL
  • Stage of the disease
  • Complications that may arise and their outcome
  • Chances for recovery and the time taken to recover
  • Recurrence of the disease
  • General health condition of the patient

The median life–expectancy of patients is as follows-

  • Low-risk group: 14+ years
  • Intermediate risk group: 8 years
  • High–risk group: 4 years

Some of the CLL indicators and their impact on prognosis is given below-

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SNo. INDICATOR PROGNOSTIC IMPLICATIONS
1 <1 yr lymphocyte doubling time Advanced
2 Hb level
<100g/l in women and <110g/l in men

Advanced
3 Bone marrow histology:
-Diffuse
-Non-diffuse

Advanced
Better prognosis
4 Enzyme Zap-70 Advanced
5 Beta2microglobulin
<2.0mg/l
>2.0mg/l

Better prognosis
Advanced
6 IgVH genes
-Mutated
-Unmutated

Better prognosis
Poor prognosis
7 Elevated Lactate Dehydrogenase levels Poor prognosis
8 CD38 expression
<30%
>30%

Better prognosis
Poor prognosis
9 Increased CD23 in blood Advanced state
10 Chromosomal abnormalities like
11qdel,17p del and p53 gene del

Poor prognosis

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