A Retrospective Analysis of CLL Patients in a Romanian Hematology Center

Background: Chronic lymphocytic leukemia (CLL) is the most common form of leukemia in adults and is characterized by a heterogeneous clinical course. Understanding real-world management and prognostic factors is essential for optimizing outcomes. Methods: We conducted a retrospective study of 112 CLL patients treated at Colentina Clinical Hospital, Bucharest, from January 2009 to June 2025. Clinical and biological data—including Binet stage, Charlson Comorbidity Index (CCI), cytogenetic and molecular markers—were collected and analyzed. Time to first treatment (TTFT), treatment patterns, and response rates were evaluated. Statistical tests included MannWhitney U and Fisher’s exact test, with p 0.05 considered significant. Results: The cohort had a median age of 65 years, with a male predominance (58%). Binet stages A, B, and C were distributed as 43.8%, 42.0%, and 14.3%, respectively. Half of the patients remained in watch and wait, while 50% initiated treatment after a median TTFT of 2.2 months. The most used first-line regimens were Obinutuzumab-Venetoclax (25.5%), Acalabrutinib (21.8%), and Ibrutinib-Venetoclax (14.5%). Complete response was achieved in 70.9% of treated patients. Treatment initiation correlated significantly with Binet stage (p 0.001), and trends were observed with unmutated IGHV (91.3% treated), and high-risk cytogenetics (75.0% treated). A CCI score >4 was associated with a 21.12% increased risk of death (p = 0.005). Conclusions: In this real-world cohort, Binet stage remained a strong predictor of treatment initiation, while comorbidities and molecular markers showed variable influence. These findings highlight the value of integrating clinical staging with molecular profiling to guide therapeutic decisions in CLL