Prognostic factors for survival in patiens with chronic lymphocytic leukemia

The purpose of this study is to analyse the quality of the
prognostic factors to prognose the survival time and progression
for patients with chronic lymphocytic leukemia (CLL) in early
stage. In CLL-1-Protocol of the German CLL Study Group (GCLLSG) 877
patients with CLL in Binet stage A were included. These patients
were assessed in terms of their progression risk using clinical and
biological prognostic factors: bone marrow histology (infiltration
type), lymphocyte doubling time (LDT), serum thymidine kinase, and
serum-ß2-microglobulin. The patients with high progression risk
would after randomization either receive treatment with fludarabine
or only be observed, whereas the patients without high progression
risk would be observed. In this study 630 patients without any
treatment with fludarabine were analysed, 95 patients (15.1%) with
high progression risk and 535 patients (84.9%) with low progression
risk. The median observation time was 6 years. The following
factors were analysed in this study: B symptoms, ECOG performance
status, alkaline phosphatase, serum glutamic oxaloacetic
transaminase (SGOT), serum glutamate pyruvate transaminase (SGPT),
gamma-glutamyltransferase (gamma-GT), cholinesterase (CHE), lactate
dehydrogenase (LDH), blood urea nitrogen (BUN), uric acid, serum
creatinine, total bilirubin, hepatomegaly, splenomegaly,
lymphadenopathy. In summary of the analysis in this study in terms
of progression free survival, six parameters (lactate
dehydrogenase, blood urea nitrogen, serum creatinine, splenomegaly,
axillary lymphadenopathy, cervical lymphadenopathy) significantly
predicted progression free survival. Patients with lactate
dehydrogenase >= 250 U/L showed significant lower progression
free survival ( 18.1 months vs. 60.6 months, p value