Abstract
Introduction: Pleural effusions in patients with chronic lymphocytic leukemia (CLL) occur infrequently.We present a comprehensive study of pleural effusions in CLL with a focus on etiology, characteristics of pleural fluid, and clinical outcome.
Methods: The Mayo Clinic CLL database is a well-organized and established repository of information on all CLL patients seen at our institution from 1995 onwards and was used to identify all CLL patients who underwent a thoracentesis at our facility from Jan 2000 to Jan 2016.
Results: 83/2160 CLL patients (3.8%) underwent one or more thoracentesis at our institution in the study period. A total of 44 patients underwent a single thoracentesis with 20 patients undergoing 2 thoracenteses and 19 patients undergoing 3 or more procedures (range 1-12). The median initial thoracentesis volume was 700 ml (IQR 198-1063 ml). Effusions were characterized as straw colored/clear in 34 patients; serosanguinous in 23; bloody in 14; milky in 2 and cloudy in 2 patients. Lights criteria classified these effusions as either transudative (n=22) or exudative (n=40). Pleural fluid lipid analysis was done in 23 patients of whom 8 were found to have a chylothorax. A total of 11 patients (13%) underwent either open thoracotomy or a video assisted thoracoscopy procedure in relation to the pleural effusion.
Conclusions: We present our initial analysis of pleural effusions in patients with CLL. We report a 4% incidence of pleural effusions requiring thoracentesis in patients with CLL. Roughly half the patients experienced a recurrent pleural effusion that required a repeat thoracentesis and a substantial fraction required surgical thoracoscopy.
- Copyright ©the authors 2016