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Prognostic Impact of Positive Direct Coombs Test in Chronic Lymphocytic Leukemia (CLL)
Abstracts Chronic Lymphocytic Leukemia
Table 1 Characteristics of Patients with CLL Classified by Coomb’s Test Status Parameter
CLL-031
Coomb’s-ve (n[43)
5911
5812
0.721 0.108
Age (years) mean SD
Prognostic Impact of Positive Direct Coombs Test in Chronic Lymphocytic Leukemia (CLL)
Gender Male N (%) White blood cells
1
Clinical Hematology Unit, Internal Medicine Department, Assiut
11(40.7%)
26(60.5%) 96117
0.057
82
102.7
0.002*
platelets
149.991
14960
Lactate dehydrogenase
564.8242
528.6317.8
0.540
76.852.3
46.235.9
0.047
Albumin
37.34.3
38.56.4
0.410 0.001**
Rai Stage N (%) Stage 0-2
4(14.8%)
23(53.5%)
Qena University Hospital, Qena, Egypt; 3Clinical Pathology Depart-
Stage 3-4
23(85.2%)
20(46.5%)
Overall response
13(48.1%)
28(65.1%)
No response
14(51.9%)
15(34.9%)
ment, Assiut University Hospital, Assiut, Egypt
-
Clinical Lymphoma, Myeloma & Leukemia September 2017
0.621
ESR
University Hospitals, Assiut, Egypt; 2Internal Medicine Department,
Background: In developing countries, access to molecular prognostic markers of CLL as IgHV mutation status is restricted by limited financial resources, looking for simple prognostic markers could help in decision making and patient counseling. The clinical course of patients with B-cell CLL is often complicated by autoimmune phenomena. Positive direct coombs test as indicator of autoimmune hemolytic anemia could benefit in this issue. Objectives: To evaluate direct coombs test as a simple prognostic marker in CLL patients thru correlation with other clinical and biomarkers at diagnosis and how it could affect CLL outcomes. Patients and Methods: Seventy patients with chronic lymphocytic leukemia diagnosed between January 2011 and December 2015 in Clinical Hematology Unit, Internal Medicine department, Assiut University hospital were included in the study. Correlations with Complete blood count, LDH levels and Rai staging were determined. CLL outcomes as overall response (CR & PR) at the end of fourth cycle of chemotherapy (CVP, FC, CHOP, ChlP), progression free survival (PFS) and overall survival (OS) were evaluated. Results: Median age was 60 years (range 20-85 years).Out of 70 patients, 37(52.8%) were males. Coombs test positivity was found in 27 patients (38.6%). Coombs positive patients had significantly low mean hemoglobin of 8.02.0 gm/dl compared with negative patients having a mean hemoglobin level of 102.7 gm/dl (P¼0.002). Coombs positivity showed a positive association with advanced disease; Rai stage III-IV (P¼0.001). No associations were noted with age, gender and other biochemical markers. Median follow up period was 39 months, the 3-year PFS of patients with positive comb’s test was significantly lower than patients with negative coombs test (23.3% vs. 61.7%, p ¼ 0.005) (Fig. 1).No significant association was found with overall response (CR & PR) to chemotherapy or overall survival (p¼0.448 & 0.745) respectively. Conclusion: Coombs test might provide a simple prognostic tool in CLL patients with poor progression free survival when test is positive.
P value
173.8173.6
Hemoglobin
Mostafa F. Mohammed Saleh ,1 Shimaa Abdelallah,1,2 Mai M. Aly,1 Ghada Elsayed,1 Yomna Refaat,1 Nourhan Taleb,1 Asma Nady,1 Maha Abdel Aziz,1 Eman M. Nagiub Abdelsalam3
S298
Coomb’s+ve (n[27)
Response to chemotherapy 0.448
*independent T test **chi square test.
CLL-035 Chronic Lymphocytic Leukemia in Brazil: Analysis of 1903 Cases Matheus Goncalves ,1 Celso Arrais Rodrigues,1,2 Irene Lorand-Metze,3 Marcelo de Lacerda,1 Maria de Lourdes Chauffaille,1 Alita Azevedo,4 Cintia Machado,4 Carlos Chiattone,5,6 Sérgio Fortier,5 Leila Perobelli,7 Maura Rosane Ikoma,8 Nelma Clementino,9 Nelson Hamerschlak,10 Inara Arce,11 Vivia Sthel,11 Larissa Ommati,12 Danielle Leão de Farias,13 Fernando Duarte,14 Valeria Buccheri,15 Ana Paula de Azambuja,16 Denise de Almeida,17 Vera Lucia de Figueiredo,11 Mihoko Yamamoto1 1
Universidade Federal de São Paulo, São Paulo, Brazil; 2Hospital Sírio
Libanês, São Paulo, Brazil; 3Universidade de Campinas, Campinas, Brazil; 4Hemocentro de Pernambuco, Recife, Brazil; 5Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil; 6Hospital Samaritano, São Paulo, Brazil; 7Hospital de Transplantes Euryclides de Jesus Zerbini / Hospital Brigadeiro, São Paulo, Brazil; 8Hospital Amaral Carvalho, Jaú, Brazil; 9Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; 10Hospital Israelita Albert Einstein, São Paulo, Brazil; 11
Hospital do Servidor Público Estadual, São Paulo, Brazil; 12Casa de
Saúde Santa Marcelina, São Paulo, Brazil; 13Universidade Federal de Goiás, Goiânia, Brazil;
14
Universidade Federal do Ceará, Fortaleza,
15
Brazil; Instituto de Cancer de São Paulo, São Paulo, Brazil; 16Universidade Federal do Paraná, Curitiba, Brazil; 17Hospital São Vicente de Paulo, Passo Fundo, Brazil
Context: The clinical course of chronic lymphocytic leukemia (CLL) in a multicultural developing country with economical and health inequalities, such as Brazil, has not been accurately determined. Objective: To evaluate “real world” CLL clinical
Table 1 Characteristics of Patients with CLL Classified by Coomb’s Test Status Parameter
CLL-031
Coomb’s-ve (n[43)
5911
5812
0.721 0.108
Age (years) mean SD
Prognostic Impact of Positive Direct Coombs Test in Chronic Lymphocytic Leukemia (CLL)
Gender Male N (%) White blood cells
1
Clinical Hematology Unit, Internal Medicine Department, Assiut
11(40.7%)
26(60.5%) 96117
0.057
82
102.7
0.002*
platelets
149.991
14960
Lactate dehydrogenase
564.8242
528.6317.8
0.540
76.852.3
46.235.9
0.047
Albumin
37.34.3
38.56.4
0.410 0.001**
Rai Stage N (%) Stage 0-2
4(14.8%)
23(53.5%)
Qena University Hospital, Qena, Egypt; 3Clinical Pathology Depart-
Stage 3-4
23(85.2%)
20(46.5%)
Overall response
13(48.1%)
28(65.1%)
No response
14(51.9%)
15(34.9%)
ment, Assiut University Hospital, Assiut, Egypt
-
Clinical Lymphoma, Myeloma & Leukemia September 2017
0.621
ESR
University Hospitals, Assiut, Egypt; 2Internal Medicine Department,
Background: In developing countries, access to molecular prognostic markers of CLL as IgHV mutation status is restricted by limited financial resources, looking for simple prognostic markers could help in decision making and patient counseling. The clinical course of patients with B-cell CLL is often complicated by autoimmune phenomena. Positive direct coombs test as indicator of autoimmune hemolytic anemia could benefit in this issue. Objectives: To evaluate direct coombs test as a simple prognostic marker in CLL patients thru correlation with other clinical and biomarkers at diagnosis and how it could affect CLL outcomes. Patients and Methods: Seventy patients with chronic lymphocytic leukemia diagnosed between January 2011 and December 2015 in Clinical Hematology Unit, Internal Medicine department, Assiut University hospital were included in the study. Correlations with Complete blood count, LDH levels and Rai staging were determined. CLL outcomes as overall response (CR & PR) at the end of fourth cycle of chemotherapy (CVP, FC, CHOP, ChlP), progression free survival (PFS) and overall survival (OS) were evaluated. Results: Median age was 60 years (range 20-85 years).Out of 70 patients, 37(52.8%) were males. Coombs test positivity was found in 27 patients (38.6%). Coombs positive patients had significantly low mean hemoglobin of 8.02.0 gm/dl compared with negative patients having a mean hemoglobin level of 102.7 gm/dl (P¼0.002). Coombs positivity showed a positive association with advanced disease; Rai stage III-IV (P¼0.001). No associations were noted with age, gender and other biochemical markers. Median follow up period was 39 months, the 3-year PFS of patients with positive comb’s test was significantly lower than patients with negative coombs test (23.3% vs. 61.7%, p ¼ 0.005) (Fig. 1).No significant association was found with overall response (CR & PR) to chemotherapy or overall survival (p¼0.448 & 0.745) respectively. Conclusion: Coombs test might provide a simple prognostic tool in CLL patients with poor progression free survival when test is positive.
P value
173.8173.6
Hemoglobin
Mostafa F. Mohammed Saleh ,1 Shimaa Abdelallah,1,2 Mai M. Aly,1 Ghada Elsayed,1 Yomna Refaat,1 Nourhan Taleb,1 Asma Nady,1 Maha Abdel Aziz,1 Eman M. Nagiub Abdelsalam3
S298
Coomb’s+ve (n[27)
Response to chemotherapy 0.448
*independent T test **chi square test.
CLL-035 Chronic Lymphocytic Leukemia in Brazil: Analysis of 1903 Cases Matheus Goncalves ,1 Celso Arrais Rodrigues,1,2 Irene Lorand-Metze,3 Marcelo de Lacerda,1 Maria de Lourdes Chauffaille,1 Alita Azevedo,4 Cintia Machado,4 Carlos Chiattone,5,6 Sérgio Fortier,5 Leila Perobelli,7 Maura Rosane Ikoma,8 Nelma Clementino,9 Nelson Hamerschlak,10 Inara Arce,11 Vivia Sthel,11 Larissa Ommati,12 Danielle Leão de Farias,13 Fernando Duarte,14 Valeria Buccheri,15 Ana Paula de Azambuja,16 Denise de Almeida,17 Vera Lucia de Figueiredo,11 Mihoko Yamamoto1 1
Universidade Federal de São Paulo, São Paulo, Brazil; 2Hospital Sírio
Libanês, São Paulo, Brazil; 3Universidade de Campinas, Campinas, Brazil; 4Hemocentro de Pernambuco, Recife, Brazil; 5Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil; 6Hospital Samaritano, São Paulo, Brazil; 7Hospital de Transplantes Euryclides de Jesus Zerbini / Hospital Brigadeiro, São Paulo, Brazil; 8Hospital Amaral Carvalho, Jaú, Brazil; 9Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; 10Hospital Israelita Albert Einstein, São Paulo, Brazil; 11
Hospital do Servidor Público Estadual, São Paulo, Brazil; 12Casa de
Saúde Santa Marcelina, São Paulo, Brazil; 13Universidade Federal de Goiás, Goiânia, Brazil;
14
Universidade Federal do Ceará, Fortaleza,
15
Brazil; Instituto de Cancer de São Paulo, São Paulo, Brazil; 16Universidade Federal do Paraná, Curitiba, Brazil; 17Hospital São Vicente de Paulo, Passo Fundo, Brazil
Context: The clinical course of chronic lymphocytic leukemia (CLL) in a multicultural developing country with economical and health inequalities, such as Brazil, has not been accurately determined. Objective: To evaluate “real world” CLL clinical