Lev Shvidel1, Osnat Bairey2, Tamar Tadmor3, Andrei Braester4, Rosa Ruchlemer5, Riva Fineman6, Erel Joffe2, Alain Berrebi7, Aaron Polliack8. 1. Kaplan Medical Center, Rehovot, Israel levsh@clalit.org.il. 2. Rabin Medical Center, Petah-Tikva, Israel. 3. Bnai Zion Medical Center, Haifa, Israel. 4. Western Galilee Hospital, Naharyia, Israel. 5. Shaare Zedek Medical Center, Jerusalem, Israel. 6. Rambam Medical Center, Haifa, Israel. 7. Kaplan Medical Center, Rehovot, Israel. 8. Hebrew University Medical School, Jerusalem, Israel.
Abstract
UNLABELLED: BACKGROUND/ AIM: The prognostic significance of hyperleukocytosis in chronic lymphocytic leukemia (CLL) remains uncertain. The aim of the present study was to evaluate the clinical characteristics and outcome of patients with CLL and white blood count (WBC) >150×10(6)/l at the time of diagnosis. PATIENTS AND METHODS: Using the database of the Israeli CLL Study Group, which includes 1,507 cases, we identified 41 patients diagnosed with WBC >150×10(6)/l and analyzed the survival in the group that was 62 months compared to 174 months in patients without hyperleukocytosis (p<0.001). However, multivariate analysis demonstrated that the WBC count had no predictive value in relation to survival time. While in the entire patient cohort advanced age and Binet stage, presence of thrombocytopenia and ZAP-70 expression were independently associated with poor prognosis, these parameters lost their prognostic value in patients with hyperleukocytosis. CONCLUSION: Although our results do not confirm that high initial levels of WBC are independently associated with shorter survival in CLL, the clinical course in these cases appears to be aggressive and conventional prognostic factors are not valid in this patient sub-group. Copyright
UNLABELLED: BACKGROUND/ AIM: The prognostic significance of hyperleukocytosis in chronic lymphocytic leukemia (CLL) remains uncertain. The aim of the present study was to evaluate the clinical characteristics and outcome of patients with CLL and white blood count (WBC) >150×10(6)/l at the time of diagnosis. PATIENTS AND METHODS: Using the database of the Israeli CLL Study Group, which includes 1,507 cases, we identified 41 patients diagnosed with WBC >150×10(6)/l and analyzed the survival in the group that was 62 months compared to 174 months in patients without hyperleukocytosis (p<0.001). However, multivariate analysis demonstrated that the WBC count had no predictive value in relation to survival time. While in the entire patient cohort advanced age and Binet stage, presence of thrombocytopenia and ZAP-70 expression were independently associated with poor prognosis, these parameters lost their prognostic value in patients with hyperleukocytosis. CONCLUSION: Although our results do not confirm that high initial levels of WBC are independently associated with shorter survival in CLL, the clinical course in these cases appears to be aggressive and conventional prognostic factors are not valid in this patient sub-group. Copyright