Pathogenesis, prevalence, and prognostic significance of cytopenias in chronic lymphocytic leukemia (CLL): A retrospective comparative study of 213 patients from a national CLL database of 1,518 cases

Lev Shvidel*, Tamar Tadmor, Andrei Braester, Osnat Bairey, Naomi Rahimi-Levene, Yair Herishanu, Abraham Klepfish, Mordechai Shtalrid, Alain Berrebi, Aaron Polliack

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

22 Scopus citations

Abstract

Utilizing the database of the Israeli CLL Study Group, we investigated the prevalence and prognostic significance of anemia and thrombocytopenia in patients with chronic lymphocytic leukemia (CLL). Of 1,477 patients, 113 had anemia and thrombocytopenia associated with "infiltrative" marrow failure, median survival of 41 and 86 months, respectively. Autoimmune cytopenias were diagnosed in 100 patients, autoimmune hemolytic anemia (AIHA) in 80, and immune thrombocytopenia (ITP) in 31, while 11 had both co-existent. Median survival of patients with AIHA and ITP, from CLL diagnosis, was 96 and 137 months, respectively, but 29 and 75 months from onset of cytopenia. Patients with AIHA from the time of CLL diagnosis had a significantly shorter survival than those without anemia (p <.0001). Survival was similar for patients with AIHA or anemia due to "infiltrative" bone marrow failure (p =.44). The presence of positive antiglobulin test even without hemolysis was associated with worse outcome. Overall survival of patients with ITP and those without cytopenias (p = 0.94) were similar. In conclusion, laboratory or clinical evidence of AIHA has a significant negative impact on the survival of patients with CLL. Outcome for cases with ITP and patients without cytopenias was similar.

Original languageEnglish
Pages (from-to)661-667
Number of pages7
JournalAnnals of Hematology
Volume92
Issue number5
DOIs
StatePublished - May 2013

Keywords

  • Autoimmune hemolytic anemia
  • CLL
  • Cytopenia
  • Immune thrombocytopenia

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