Prognostic Role of Platelet _lymphocyte and Neutrophil _monocyte in CLL
Prognostic Role of Platelet _lymphocyte and Neutrophil _monocyte in CLL
The biological rationale in calculating PLR stems from the increase in the lymphocyte count
 and reduction in the platelet count often encountered in the advances stages of CLL .NMR
 median value was significantly higher in untreated patients than in patients who received
 treatment strengthening the hypothesis that this ratio is associated with a more indolent
 form of disease
Chronic lymphocytic leukemia (CLL) is the most common type of leukemia in the western world.
 In Egypt, CLL is the most common subtype of leukemias

 -  the National Cancer Registry reported over 80% of lymphoid leukemias are CLL . It is the
 most common types of leukemia diagnosed in adult.
 ChroniclymphocyticleukemialymphocytesareclonalCD19-positiveBcells characterized by the
 accumulation of CD5 positive monoclonal B cells in peripheral blood. Bone marrow
 aspiration shows lymphocytic replacement of normal marrow elements, lymphocytes comprise
 25-95% .Trephine biopsy reveals nodular, diffuse or interstitial involvement by
 lymphocytes

 -  Both the International Workshop on Chronic Lymphocytic Leukemia (IWCLL) and European
 Society of Medical Oncology guidelines also require persistence of lymphocytosis for
 longer than 3 months

 The most important prognostic factors in CLL are clinical staging systems developed by Rai
 and Binet

 . These systems based on clinical examination e.g. lymphadenopathy and organomegaly,
 peripheral blood findings (platelet
 andhaemoglobinvalues),markersoftumorload(thymidinekinaseand B2-microglobulin), expression of
 specific proteins in CLL cells; CD38, CD49d & ZAP-70, genetic abnormalities quantified by
 FISH which include del(13q), tri12, del(11q), & del(17p) and genetic parameters.including
 immunoglobulin heavy chain variable gene segment (IGHV) mutational status. Finally,
 prognostication in patients with CLL should not only address disease progression and overall
 survival, but also response to therapy. The biological rationale in calculating PLR stems
 from the increase in the lymphocyte count and reduction in the platelet count often
 encountered in the advanced stages of CLL. Therefore, we hypothesized that the ratio using
 both the platelet and lymphocyte counts may have a prognostic role in patients with CLL.
 Neutrophil-monocyte ratio(NMR) was found to be higher in untreated patients than in patients
 who received treatment . and therefore it will be used to prove its relation with disease
 severity and itsprognosticvalues. It is important to highlight that using these indices, is
 simple, cheap, easily measured and reproducible and can be integrated into our daily clinical
 practice as prognostic marker of CLL
Inclusion Criteria:

 - All CLL patients

 Exclusion Criteria:

 -  CLL patients on treatment