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Læknablaðið - 01.04.2016, Blaðsíða 17

Læknablaðið - 01.04.2016, Blaðsíða 17
LÆKNAblaðið 2016/102 177 R A N N S Ó K N Heimildir 1. Dighiero G, Hamblin TJ. Chronic lymphocytic leukaemia. Lancet 2008; 371: 1017-29. 2. Hallek M. Signaling the end of chronic lymphocytic leu- kemia: new frontline treatment strategies. Blood 2013; 122: 3723-34. 3. Hallek M, Cheson BD, Catovsky D, Caligaris-Cappio F, Dighiero G, Dohner H, et al. Guidelines for the diagnos- is and treatment of chronic lymphocytic leukemia: a report from the International Workshop on Chronic Lymphocytic Leukemia updating the National Cancer Institute-Working Group 1996 guidelines. Blood 2008; 111: 5446-56. 4. Swerdlow SH, Campo E, H. NL., eds. World Health Organization Classification of Tumours of Haematopoietic and Lymphoid Tissues, I. ARC Press, Lyon 2008. 5. Shanafelt TD, Byrd JC, Call TG, Zent CS, Kay NE. Narrative review: initial management of newly diagnos- ed, early-stage chronic lymphocytic leukemia. Ann Intern Med 2006; 145: 435-47. 6. Montserrat E, Sanchez-Bisono J, Vinolas N, Rozman C. Lymphocyte doubling time in chronic lymphocytic leuka- emia: analysis of its prognostic significance. Br J Haematol 1986; 62: 567-75. 7. Rawstron AC, Bennett FL, O‘Connor SJ, Kwok M, Fenton JA, Plummer M, et al. Monoclonal B-cell lymphocytosis and chronic lymphocytic leukemia. N Engl J Med 2008; 359: 575-83. 8. Landgren O, Albitar M, Ma W, Abbasi F, Hayes RB, Ghia P, et al. B-cell clones as early markers for chronic lymphocytic leukemia. N Engl J Med 2009; 360: 659-67. 9. Rossi D, Sozzi E, Puma A, De Paoli L, Rasi S, Spina V, et al. The prognosis of clinical monoclonal B cell lymphocytosis differs from prognosis of Rai 0 chronic lymphocytic leuka- emia and is recapitulated by biological risk factors. Br J Haematol 2009; 146: 64-75. 10. Rawstron AC, Green MJ, Kuzmicki A, Kennedy B, Fenton JA, Evans PA, et al. Monoclonal B lymphocytes with the characteristics of „indolent“ chronic lymphocytic leukem- ia are present in 3.5% of adults with normal blood counts. Blood 2002; 100: 635-9. 11. Marti GE, Carter P, Abbasi F, Washington GC, Jain N, Zenger VE, et al. B-cell monoclonal lymphocytosis and B-cell abnormalities in the setting of familial B-cell chronic lymphocytic leukemia. Cytometry B Clin Cytom 2003; 52: 1-12. 12. Hernandez JA, Land KJ, McKenna RW. Leukemias, myeloma, and other lymphoreticular neoplasms. Cancer 1995; 75(1 Suppl): 381-94. 13. Goldin LR, Pfeiffer RM, Li XJ, Hemminki K. Familial risk of lymphoproliferative tumors in families of patients with chronic lymphocytic leukemia: results from the Swedish Family-Cancer Database. Blood 2004; 104: 1850-4. 14. Cuttner J. Increased incidence of hematologic malign- ancies in first-degree relatives of patients with chronic lymphocytic leukemia. Cancer Invest 1992; 10: 103-9. 15. Yamamoto JF, Goodman MT. Patterns of leukemia incidence in the United States by subtype and demograp- hic characteristics, 1997-2002. Cancer Causes Control 2008; 19: 379-90. 16. Sant M, Allemani C, Tereanu C, De Angelis R, Capocaccia R, Visser O, et al. Incidence of hematologic malign- ancies in Europe by morphologic subtype: results of the HAEMACARE project. Blood 2010; 116: 3724-34. 17. Ahmad O, Boschi-Pinto C, Lopez A, Murray C, Lozano R, Inoue M. Age standardization of rates: a new who standard in GPE Discussion Paper Series, W.H. Organization, Editor. 2001. 18. Zent CS, Kyasa MJ, Evans R, Schichman SA. Chronic lymphocytic leukemia incidence is substantially higher than estimated from tumor registry data. Cancer 2001; 92: 1325-30. 19. Turesson I, Linet MS, Bjorkholm M, Kristinsson SY, Goldin LR, Caporaso NE, et al. Ascertainment and diagnostic accuracy for hematopoietic lymphoproliferative malign- ancies in Sweden 1964-2003. Int J Cancer 2007; 121: 2260-6. 20. Jónasson JG, Tryggvadóttir L. Krabbamein á Íslandi - Upplýsingar úr Krabbameinsskrá fyrir tímabilið 1955- 2010. Krabbameinsfélagið, Reykjavík 2012. 21. Baliakas P, Mattsson M, Stamatopoulos K, Rosenquist R. Prognostic indices in chronic lymphocytic leukaemia: where do we stand how do we proceed? J Intern Med 2016; 279: 347-57. 22. Goede V, Fischer K, Busch R, Engelke A, Eichhorst B,. Wendtner CM et al. Obinutuzumab plus Chlorambucil in Patients with CLL and Coexisting Conditions. N Engl J Med 2014; 370: 1101-10. 23. De Angelis R, Minicozzi P, Sant M, Dal Maso L, Brewster DH, Osca-Gelis, et al. Survival variations by country and age for lymphoid and myeloid malignancies in G. Europe 2000-2007: Results of EUROCARE-5 population-based study. Eur J Cancer 2015. ENGLISH SUMMARY Introduction: Chronic lymphocytic leukemia (CLL) is characterized by the proliferation of monoclonal B-lymphocytes. MBL (monoclonal B-cell lymphocytosis) is considered a precursor state of the disease. Although CLL is incurable it is an indolent disorder and often detected incidentally on routine blood counts. Until now little information has been available on CLL in Iceland, including the incidence, diagnosis, symptoms or MBL precursor state. Material and methods: This is a retrospective, descriptive study inclu- ding CLL patients diagnosed in Iceland over the years 2003-2013. Reg- istries of patients with a CLL diagnosis were obtained from the Icelandic Cancer Registry, Landspitali National University Hospital and the Med- ical Center in Mjódd. Medical records were reviewed for information on symptoms, diagnosis and treatment. Survival data and causes of death were obtained from national registries. Results: The number of patients diagnosed with CLL over the study period was 161 (109 males, 52 females). The calculated incidence was 4.55/100,000, and the age-standardized incidence was 3.00/100,000. Mean age at diagnosis was 70.9 years (range 35-96 years). The Icelandic Cancer Registry lacked information on 28 patients (17.4%). The initial diagnosis of CLL was obtained exclusively with flow cytometry in 47.2% of cases. Symptoms were present at diagnosis in 67 of 151 patients (44.4%). One third of the group received chemotherapy and the average time to treatment was 1.3 years. Five-year survival was 70% and median survival was 9.4 years. Elevated lymphocyte counts (≥4,0x109/L) in perip- heral blood prior (0.1 to 13.4 years) to diagnosis of CLL was identified in 85 of 99 CLL patients (85.9%). Conclusion: The incidence of CLL in Iceland is similar to other Western countries. The registration of CLL cases in the Icelandic Cancer Registry must be improved, especially in cases where diagnosis is based solely on flow cytometry. Elevated lymphocyte counts were present in a large proportion of cases prior to the diagnosis of CLL. Chronic lymphocytic leukemia in Iceland from 2003 to 2013: Incidence, presentation and diagnosis Gunnar Björn Olafsson1, Hlif Steingrimsdottir2, Brynjar Vidarsson2,3, Anna Margret Halldorsdottir4 1Faculty of Medicine, University of Iceland, 2Department of Hematology, Landspitali, 3Specialist Clinic in Mjodd, 4The Blood Bank, Landspitali. Key words: Chronic lymphocytic leukemia, CLL, monoclonal B-cell lymphocytosis, MBL, incidence, diagnosis. Correspondence: Anna Margrét Halldórsdóttir, annamha@landspitali.is

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