[HEPATIC MANIFESTATIONS OF CHRONIC LYMPHOCYTIC LEUKEMIA AND CORRELATION WITH PROGNOSIS].

Abstract

Introduction: Chronic lymphocytic leukemia (CLL) is the most common leukemia in the Western world. Liver function tests (LFT) revealing impairment are described in 5% of CLL patients. Although these effects are described in the literature, their occurrence at the diagnosis of CLL and correlation with prognostic data have rarely been evaluated. We aimed to evaluate the prevalence of impairment of different LFT at CLL diagnosis and its correlation with prognosis.

Methods: This is a descriptive observational retrospective study. Diagnostic and prognostic data from CLL patients followed at Bnai Zion Medical Center were collected from charts for the period January 1st, 2000 until October 6, 2020. A t-test for continuous variables, Chi-2 and Fisher-exact tests for discrete variables, and log-rank test for survival analysis, were performed to evaluate prognostic correlations of impaired as compared with normal LFT. The significance level was defined as p value < 0.05.

Results: Overall, 153 patients with CLL diagnosed from 2000 until 2020 were included. The median age was 66 (42-89) years, and 62 were women (40.5%). Before CLL treatment initiation, mildly elevated cholestatic enzymes were encountered among 12% patients, while hepatocellular enzymes were elevated in only 2%. After excluding patients with hemolysis, hyperbilirubinemia was found among 5% of the patients. Cholestatic impairment was associated with negative prognostic data, especially increased alkaline phosphatase levels which was associated with a shorter overall survival (p=0.001).

Conclusions: Impairment of cholestatic enzymes and hyperbilirubinemia is not rare before CLL treatment. Despite its mild impairment, it seems to be associated with worse prognosis.