Retrospective Study of Naïve CLL Patients

In total, 113 patients diagnosed with naïve CLL at Seoul St. Mary’s Hospital, Catholic University of Korea, from March 2018 to December 2021 were included in the study. Patients were diagnosed according to the World Health Organization (WHO) Classification of Tumors of Hematopoietic and Lymphoid Tissues on the basis of their clinical features, laboratory findings (PB and/or BM morphology, and flow cytometric immunophenotyping), cytogenetics, and molecular genetics [1 (link)]. Morphologic characteristics of CLL were reviewed on PB smears and/or BM aspiration smears and hematoxylin and eosin-stained tissue sections and confirmed independently by two experienced hematopathologists to exclude other small B-cell lymphomas. CLL with atypical immunophenotype was regarded when either CD5 or CD23 were negative or dim positive (−/dim+), or when FMC7 is positive [60 ]. Extramedullary involvement and localization were assessed using positron emission tomography/computed tomography. Initial staging was performed according to the Rai and Binet systems [61 (link),62 (link)]. This study was approved by the institutional review board of Seoul St. Mary’s Hospital (KC21RISI0569).
Decision-making for treatment initiation was performed following the international workshop on CLL 2018 (iwCLL 2018) [63 (link)]. Most patients were monitored every 4–6 months without intervention because they did not exhibit any symptoms and signs of advanced disease or evidence of progressive disease (n = 73). The combination of fludarabine, cyclophosphamide, and rituximab (FCR) was the most commonly used treatment regimen (n = 22), followed by rituximab plus bendamustine (n = 6) and obinutuzumab plus chlorambucil (n = 5). Other regimens included acalabrutinib monotherapy (n = 4), acalabrutinib, venetoclax plus obinutuzumab (n = 1), venetoclax plus obinutuzumab (n = 1), and venetoclax plus acalabrutinib (n = 1).