Background: Chronic lymphocytic leukemia (CLL) is the most common leukemia in adults, including elderly veterans. Some veterans have a history of Agent Orange exposure, which may potentially impact their presentation and disease course. We sought to assess initial patterns of cytogenetic aberrations among patients with CLL within the Minneapolis VA Health Care System (MVAHCS).
Methods: For this interim analysis, we evaluated a subset (30%) of a larger sample (6,756). We reviewed clinical data from 2,015 patients with CLL diagnosed from 2000 to 2013 and identified through the National VA Tumor Registry. Baseline demographics, including bone marrow/cytogenetic findings and treatment information were collected. The objective of this study was to assess initial cytogenetic patterns and variation of these parameters by age and Agent Orange exposure.
Results: Median age at diagnosis was 69 years (range, 37-96 years); 98% were male (1,979); Rai stage was 0 (n = 1,331, 66%), 1 (n = 317, 16%), 2 (n = 156, 8%), 3 (n = 91, 5%), 4 (n = 113, 6%). Cytogenetic data were available on 590 of 2,015 (29%) patients. Cytogenetic findings were normal in 258 (44%) patients. Abnormal cytogenetic findings in the remaining 330 cases included del 13q (28%); trisomy 12 (15%); del 11q (11%); del 17p (6%); and other abnor-malities (13%). Of 330 patients with noted abnormalities, 191 (58%) had 1 abnormality; 60 (18%) had 2; and 79 (24%) had > 2 abnormalities. Out of 2,015 patients, 283 (14%) had a reported exposure to Agent Orange; cytogenetic information was available in 130 (46%). Chromosomal abnormalities were detected in 80 of 130 cases (62%). The most frequent abnormality was del 13q (40%); trisomy 12 (19%); other abnormalities (18%); and del 11q (17%). Of the 80 pa-tients with noted abnormalities, 44 (55%) had 1 abnormality;14 (18%) had 2; and 22 (28%) had > 2 abnormalities.
Conclusions: Cytogenetic abnormalities in CLL play an important role in predicting disease progression and survival. These abnormalities paired with Agent Orange exposure have yet to be explored. Utilization of the National VA Tumor Registry data will allow the opportunity to examine the impact, if any, of Agent Orange exposure on the presentation and disease course of veterans with CLL. Updated cytogenetic findings will be presented at the AVAHO annual meeting.