Incidence of lymphoid malignancies in patients with lymphocytosis identified by general practitioners
Abstract
Family physicians are currently instructed to refer patients with lymphocyte counts exceeding 5 x109/L to hematologists due to the possibility of chronic lymphocytic leukemia (CLL). This study assessed the usefulness of this procedure through the analysis and evaluation of referrals made to a hematologist over a period of 12 years (2010-2022). During the 12 years, there were 256 patients whose absolute lymphocyte count at least once exceeded 5 x109/L and who were referred to our hospital. There were 145 males and 111 females in this group, and the median age was 66 y. The mean absolute lymphocyte count at the time of referral was 30.0 G/L. It was found that among the 256 patients, a diagnosis was established for 249 (97.3%) of the patients. There were 224 CLL cases, 2 SLL cases, and 5 MBL cases, making 231 cases with CLL phenotype (92.8%). There were 9 cases of other B cell lymphomas (3.6%), including 4 MCL cases, 4 MZL cases, and 1 SLVL case. Furthermore, there were 6 cases of T cell lymphomas (2.4%), including 5 T-LGL cases and 1 T-PLL case. The cohort also had 1 AML case (0.4%) and 3 reactive lymphocytosis cases (1.2%), including one with infectious mononucleosis (0.4%). In the group, 16/224 patients (7.1%) with CLL as well as one with AML required immediate treatment. The absolute lymphocyte count was confirmed as a reliable screening test for diagnosing lymphoid malignancies with peripheral blood involvement.
Keywords: absolute lymphocyte countchronic lymphocytic leukemialymphoid malignancyscreening test
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