In recent years, patients with tumor and progressive forms of CLL are treated with fludarabine both as monotherapy and in combination with other drugs: cyclophosphamide (FC), rituximab (FCR), mitoxantrone (FCM). In the overwhelming majority of patients treated according to these protocols as the first line of therapy, they managed to achieve complete or partial remission of CLL. Since treatment according to these protocols has been carried out over the past few years, the median overall survival in this cohort has not yet been reached.
An important role in the treatment of splenic CLL was assigned to splenectomy and radiation treatment, the median survival rate was 61 months. The treatment of the abdominal form was carried out similarly to the treatment of the tumor form. The bone marrow and prolymphocytic forms of CLL were very rare. The disease in these cases was malignant, was accompanied by profound anemia and thrombocytopenia, and a fatal outcome quickly occurred.
Life expectancy was primarily affected by the stage of the disease in which hemoblastosis was diagnosed (table 5). Patients whose CLL was diagnosed in stage A according to the Binet classification had a significantly longer life expectancy than patients with B and C stages at the time of detection of the disease. Patients who had a high expression of the CD38 marker at the time of diagnosis of the disease had a significantly lower survival rate.
Infectious complications were observed in 85% of patients with CLL. The most common diseases were the bronchopulmonary system (pneumonia, bronchitis, pleurisy, etc.) – 38.8% and pathology of upper respiratory tract – 28.6%; Herpes zoster was observed less frequently – 16.3%; abscesses, phlegmon, sepsis – 5.3%; erysipelas – 5.3%; mycoses – 5.7%. In 13 people, the disease was complicated by autoimmune hemolytic anemia (5.5% of the total number of CLL patients).
Note: Pulmonary tuberculosis and chronic bronchitis were attributed to comorbidities in cases where they were previously diagnosed with CLL. The accession of these diseases on the background of CLL was attributed to its complications.