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Malignant pleural effusions in lymphoproliferative disorders.

Shahid Ahmed1, Rabia K Shahid, Rola Rimawi

  • 1Saskatoon Cancer Center, University of Saskatchewan, Saskatoon, SK, Canada. sahmed@scf.sk.ca

Leukemia & Lymphoma
|July 16, 2005
PubMed
Summary

Malignant pleural effusion is common in lymphoid cancers. Key predictors include symptoms, low mesothelial cells, and high lactate dehydrogenase (LDH) levels in pleural fluid, which also indicate mortality risk.

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Area of Science:

  • Oncology
  • Pulmonology
  • Pathology

Background:

  • Pleural effusion is a frequent complication in patients with lymphoproliferative disorders.
  • Determining the cause of pleural effusion and factors influencing mortality is crucial for patient management.

Purpose of the Study:

  • To identify variables correlating with malignant pleural effusion.
  • To determine prognostic factors for hospital mortality in patients with lymphoproliferative disorders and pleural effusion.

Main Methods:

  • Retrospective study of hospitalized patients with lymphoid malignancy and pleural effusion (1993-2002).
  • Clinical data and thoracentesis results were analyzed using logistic regression.
  • Prognostic variables for malignant effusion and hospital mortality were identified.

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Main Results:

  • Malignant pleural effusion occurred in 53% of cases.
  • Factors predicting malignant effusion included symptomatic effusion, low mesothelial cell count (<5%), high pleural fluid:serum lactate dehydrogenase (LDH) ratio (≥1), and high pleural fluid lymphocyte percentage (≥50%).
  • Hospital mortality was associated with secondary cancer, high pleural fluid:serum LDH ratio (≥1), and pneumonia.

Conclusions:

  • Malignant pleural effusion is a common cause of effusion in lymphoid malignancy.
  • Clinical and cytochemical markers, particularly the pleural fluid to serum LDH ratio, are valuable in identifying malignant effusion and predicting mortality.