EVALUATION OF THERAPEUTIC STRATEGIES AND OUTCOMES IN PATIENTS WITH CHRONIC LYMPHOCYTIC LEUKEMIA AT HAYATABAD MEDICAL COMPLEX, PESHAWAR

Abstract

Background: Chronic Lymphocytic Leukemia (CLL) is characterized by the clonal proliferation of mature, dysfunctional B-lymphocytes, leading to peripheral leukocytosis, bone marrow failure, and complications such as anemia, recurrent infections, and organomegaly. Evaluating treatment efficacy in local settings is crucial for optimizing patient management. Therefore, the purpose of this study was to assess the impact of standard therapeutic regimens on hematological and biochemical parameters in CLL patients at a tertiary care hospital in Peshawar.

Methods: A comparative cross-sectional study was conducted at Hayatabad Medical Complex (HMC). Seventy-three (n=73) adult patients (≥40 years) with diagnosed CLL were enrolled via consecutive sampling. Data on demographics, treatment regimens, and pre- and post-treatment laboratory parameters were collected. Venous blood samples were analyzed for complete blood counts and biochemical profiles using standardized automated analyzers. Statistical analysis was performed using SPSS version 26.; paired sample t-tests were used to compare pre- and post-treatment means.

Results: The cohort comprised 74% males and 26% females. Dexamethasone (86.3%) and Bendamustine (61.6%) were the most frequently administered agents. Post-treatment analysis revealed significant improvements: a substantial reduction in total white blood cell count (mean: 358.63 to 193.13 x10³/µL, p=0.001) and absolute lymphocyte count (mean: 53.30% to 38.24%, p<0.001). Bone marrow blast percentage decreased significantly (0.21% to 0.01%, p=0.001). Serum Lactate Dehydrogenase (LDH) levels also decreased significantly (217.44 to 189.53 U/L, p=0.007).

Conclusion: The therapeutic strategies, predominantly based on Bendamustine and Dexamethasone, were effective in achieving significant cytoreduction and improving key disease markers in CLL patients. The findings align with regional treatment patterns and demonstrate the efficacy of these protocols in a real-world setting.