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Immunoglobulin Gene Sequence Analysis In Chronic Lymphocytic Leukemia: From Patient Material To Sequence Interpretation
Published on: November 26, 2018
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Cardiac Surgery Outcomes in Patients With Chronic Lymphocytic Leukemia
Yuanjia Zhu1, Andrew J Toth2, Ashley M Lowry2
1Department of Thoracic and Cardiovascular Surgery, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio; Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio.
The Annals of Thoracic Surgery
|February 20, 2018
Summary
Cardiac surgery in chronic lymphocytic leukemia (CLL) patients showed similar hospital mortality rates compared to non-CLL patients. High-risk CLL patients required more blood products, necessitating careful preoperative management.
Area of Science:
- Cardiology
- Hematology
- Surgical Outcomes
Background:
- Limited data exists on surgical outcomes for patients with chronic lymphocytic leukemia (CLL) undergoing cardiac surgery.
- Investigating hospital morbidity and mortality in CLL patients post-cardiac surgery is crucial for clinical decision-making.
Purpose of the Study:
- To compare hospital morbidity and mortality after open cardiac surgery in patients with CLL versus those without the condition.
- To identify specific risks and management considerations for CLL patients undergoing elective cardiac surgery.
Main Methods:
- A retrospective study analyzed 157 CLL patients and 55,917 non-CLL patients who underwent elective cardiac surgery between May 1995 and May 2015.
- Patients were stratified by Rai criteria for CLL risk (low, intermediate, high).
- Propensity-score matching was used to compare outcomes between CLL and non-CLL groups.
Main Results:
- Hospital mortality rates were similar between CLL (2.5%) and non-CLL (3.0%) patients (p > 0.3).
- Deep sternal wound infection and septicemia rates were also comparable between groups.
- High-risk CLL patients received more blood products (87% vs. 65%) and intermediate-risk CLL patients received more platelet units (mean 12 vs. 4.6).
Conclusions:
- While overall hospital mortality is not increased, high-risk CLL patients undergoing cardiac surgery require more blood product transfusions.
- Careful preoperative assessment and management, including consideration of transfusion strategies and blood-loss reduction techniques, are essential for high-risk CLL patients.
- Transfusion-related risks should be evaluated when considering elective cardiac surgery for CLL patients.
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