Treatment Outcome & Complications of Patients with Chronic Lymphocytic Leukemia Treated at King Faisal Specialist Hospital & Research Center-Jeddah over a Decade. A single Center Experience in the Kingdom of Saudi Arabia.
Introduction/Background/Significance: Over a decade, there was a significant change in the management of patients with Chroni Lymphocytic Leukemia (CLL) from the diagnostic and therapeutic perspective. The diagnostic approaches moved from flow cytometry based diagnosis toward molecular cytogenetic with molecular profiling and immunoglobulin heavy chain mutation analysis that defined the disease and treatment options that can be offered to CLL patinets. At the same time, treatment choiced moved from chemotherapy and chemo-immunotherapy (CIT) based therapies to B cell receptor (BCR) molecular targeted therapy with the main use of Bruton Tyrosine Kinase Inhibitors (BTKi); namely Ibrutinib & Acalabrutinib.
Materials and Methods/Case Presentation/Objective: Retrospective analysis of treatment outcome and complications of patients with CLL diagnosed over a decade. IRB approval was obtained and there is no conflict of interest.
nxOver a decade, (2014-2024), 41 patients were identified with CLL, 16 women and 25 men, with a median age off 60-70. Of these 41 patients, 13 died (31%), 4 due to Richter's Transformation (RT) (31% of died patients). 3 out of these 4 cases (75%) has RT post CIT and only 1 patient was on BTKi (Ibrutinib). 2 additional cases had TY while on observational stage, one had chemo (ABVD of Hodgkin's Lymphoma). While the other had venetoclax plus R-CHOP followed by Allogeneic BMT and now he is on Ibrutinibfor GVHD & CLL relapse prevention. Of these 41 patients20 were treated with BTKi of Ibrutinib, but 8 patients (40%) were switched to Acalabrutinib due to different adverse events.
Conclusions: CLL management changed dramatically chemo-immune based to molecular targeted chemo-free therapy over a decade of care for CLL
