Abstract: Objective To explore the possible prognostic function of absolute monocyte count (AMC) for chronic lymphocytic leukemia (CLL) through the analysis of 54 CLL patients' clinical symptoms, laboratory features and follow-up data. Methods Retrospectively analyze 54 patients admitted to Department of Hematology, the Second Hospital of Shanxi Medical University from January 2002 to December 2017 with their clinical features, laboratory examinations, treatment process and outcome. Kaplan-Meier method was used to calculate the survival rate and draw the survival curve and the risk curve. Log-rank test was used to compare the survival rates between different groups. Cox proportional hazards model was used for multivariate analysis of prognostic factors in CLL. Results The male to female ratio was 2:1 among 54 cases of patients, the median age was 64-years-old. There were 8 cases belong to Binet A, 25 cases belong to Binet B and 21 cases belong to Binet C. We used disease progression to get the receiver operating characteristics (ROC) curve of AMC, the cutoff point of AMC was 0.67×10⁹/L, the optimal curve of sensitivity was 0.710, specificity was 0.783, the area under the curve (AUC) was 0.771 (95% CI:0.644-0.899). We divided the patients into high and low AMC group according to the cutoff point. There was no significant differences between high AMC group and low AMC group in overall survival (OS)(P=0.170), but progression free survival (PFS) results suggested high AMC group may progress quicker than low AMC group (P<0.05). Cox regression analysis suggested that disease stage belong to Binet C (P=0.038) was an independent factor affecting OS, while the AMC at the diagnosis>0.67×10⁹/L (P=0.004) and the Binet C stage (P=0.049) were independent risk factors of PFS. Conclusion High AMC level at diagnosis suggested rapid disease progression and may become a new evidence for the prognosis of CLL.

Key words: chronic lymphocytic leukemia, clinical features, absolute monocyte count, prognosis