Læknablaðið - 01.04.2016, Side 17

LÆKNAblaðið 2016/102 177
R A N N S Ó K N
Heimildir
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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