Pb1952: cll in aya

Topic: 6. Chronic lymphocytic leukemia and related disorders - Clinical Background: Chronic lymphocytic leukemia (CLL) is a monoclonal disorder characterized by a progressive proliferation of dysfunctional mature lymphocytes. Its disease of elderly with average age at presentation 70 years old. AYA cancer patients are defined as those patients’ ages between 15-39 years according to NCCN guidelines. CLL in AYA are less than 1% of the cases. However due to lack of enough data more knowledge and experience is needed Aims: To describe young and adolescence diagnosed with CLL in tertiary cancer hospital Methods: We retrospectively analyzed data from the clinical database of our single tertiary hematology center, The National Center for Cancer Care and Research, Doha, Qatar. All patients diagnosed with CLL during the period of January 2012 to December 2021 where included less than 40 years from (15-39) Results: Four patients out of 140 patients diagnosed with CLL in our center and their age below 40. Male and females were equal, two patients at 32 years and another two at 37. On presentation median WBC 290,000 with lymphocytosis of 56000, while median hemoglobin 7.8 and 14000 for platelets. Two patients had B symptoms, while other two incidental findings. All the patients have cervical lymphadenopathy plus or minus adenopathy in other areas. Advanced stage IV in three patients. Karyotype were different with one patient has diploid, trisomy 12, del 13q and the last patient with complex karyotype. A least one or two of the poor prognostic finding or markers were in each patient. The poor markers were CD49, atypical CD79, and CD38, extensive bone marrow infiltration, advance stage, complex karyotype or tp53. Treatments were the most challenging part within young group. One patient got pregnant while on BTKi so we have to hold, as consequence WBC has increase and lymph node were enlarged. she is for early-planed delivery so we can resume later her treatment. Another patient who received FCR 6 cycles developed PML as complications to rituximab. Third patient declined treatment not wiling for chemotherapy neither for lifelong treatment Summary/Conclusion: Although it is rare, CLL in young adult seems to be quite challenging due to negative prognostic markers for this group and for other problems withs treatment options. Childbearing age is among this group with no evident treatment options or guidelines for management. Long term complications are an issue to consider with fixed duration treatment such as Venetoclax based or other regimens. Keywords: B-CLL