Pulmonary complications in chronic lymphocytic leukemia

Abstract

BACKGROUND Although pulmonary complications account for significant morbidity and mortality in patients with chronic lymphocytic leukemia (CLL), to the authors' knowledge there are sparse data available in published literature. The authors evaluated pulmonary complications in patients with CLL and identified prognostic variables that predict hospital mortality in these patients. METHODS Clinical data were analyzed retrospectively from patients with CLL who required hospitalization for a respiratory illness at a tertiary care institution from January 1993 to December 2001. A logistic regression analysis with a backward elimination procedure was carried out to determine prognostic variables that predict hospital mortality. RESULTS There were 110 patients who were admitted on 142 occasions with a pulmonary complication. The median age was 75 years (range, 43–97 years), and the male:female ratio was 1.7:1.0. Among 142 admissions, 68% were high risk according to the Rai criteria, 68% of patients admitted had received prior therapy for CLL, and 35% had received treatment within 3 months of admission. The most common pulmonary complications were pneumonias (75%), malignant pleural effusion/and or lung infiltrate due to CLL (9%), pulmonary leukostasis (4%), Richter transformation or nonsmall cell lung carcinoma (3%), and upper airway obstruction (2%). Forty‐four of 110 patients (40%) died. In multivariate analysis, admission absolute neutrophil counts ≤ 0.5 × 109/L (odds ratio, 4.6; 95% confidence interval [95% CI], 1.3–16.6) and blood urea nitrogen (BUN) levels ≥ 20 mg/dL (odds ratio, 3.0; 95% CI, 1.1–8.3) were correlated significantly with mortality. CONCLUSIONS Pneumonia was the major pulmonary complication in hospitalized patients with CLL. Severe neutropenia and high BUN levels were correlated significantly with increased mortality. Cancer 2003. © 2003 American Cancer Society.

Assessment of circulating biochemical markers and antioxidative status in acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) patients

“…Research studies describe that not only in acute leukemias but also in chronic leukemias like in case of CLL (chronic lymphocytic leukemia) pneumonia, BUN was a major pulmonary complication. Patients have higher levels of BUN and severe neutropenia which were correlated with the mortality of leukemia patients (Ahmed et al, 2003). Antioxidant enzymes interact with the free radicals in different ways, by controlling the chain of reactions.…”

Flow Cytometry and Effusions in Lymphoproliferative Processes and Other Hematologic Neoplasias

“…For CLL/SLL in autopsy series, pleural involvement has ranged from 3 to 16% [17]. The appearance of malignant cells of this lymphoma type in body cavity effusions is common, and it is diagnosed mostly several years after the first diagnosis of the tumor [18,19]. It can easily be proven via FC by demonstration of a light chain-restricted CD19+, CD20+ B-cell population coexpressing CD5 and CD23 but lacking CD10.…”

Chronic Lymphocytic Leukemia: A Paradigm of Innate Immune Cross-Tolerance

“…Several studies indicated that .50% of patients with CLL suffer from pathogen colonization, causing the death of 70% of these patients (4)(5)(6)(7)(8)(9)(10). Other studies reported that 80% of patients with CLL suffer from infections (11). A number of published studies postulated that the hypogammaglobulinemia suffered by these patients accounts for their high infection rate (4,5,10).…”