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Bispebjerg Hospital - a part of Copenhagen University Hospital
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Pre-diagnostic trajectories of lymphocytosis predict time to treatment and death in patients with chronic lymphocytic leukemia

Research output: Contribution to journalJournal articlepeer-review

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    Research output: Contribution to journalJournal articlepeer-review

  • Michael Asger Andersen
  • Mia Klinten Grand
  • Christian Brieghel
  • Volkert Siersma
  • Christen Lykkegaard Andersen
  • Carsten Utoft Niemann
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Background: The dynamics of pre-diagnostic lymphocytosis in patients with ensuing chronic lymphocytic leukemia (CLL) need to be explored as a better understanding of disease progression may improve treatment options and even lead to disease avoidance approaches. Our aim was to investigate the development of lymphocytosis prior to diagnosis in a population-based cohort of patients with CLL and to assess the prognostic information in these pre-diagnostic measurements.

Methods: All patients diagnosed with CLL in the Greater Copenhagen area between 2008 and 2016 were included in the study. Pre-diagnostic blood test results were obtained from the Copenhagen Primary Care Laboratory Database encompassing all blood tests requested by Copenhagen general practitioners. Using pre-diagnostic measurements, we developed a model to assess the prognosis following diagnosis. Our model accounts for known prognostic factors and corresponds to lymphocyte dynamics after diagnosis.

Results: We explore trajectories of lymphocytosis, associated with known recurrent mutations. We show that the pre-diagnostic trajectories are an independent predictor of time to treatment. The implementation of pre-diagnostic lymphocytosis slope groups improved the model predictions (compared to CLL-IPI alone) for treatment throughout the period. The model can manage the heterogeneous data that are to be expected from the real-world setting and adds further prognostic information.

Conclusions: Our findings further knowledge of the development of CLL and may eventually make prophylactic measures possible.

Original languageEnglish
JournalCommunications medicine
Volume2
Pages (from-to)50
ISSN2730-664X
DOIs
Publication statusPublished - 2022

Bibliographical note

© The Author(s) 2022.

ID: 78225438