Liver dysfunction at diagnosis can impact survival

This study examined whether the presence of liver dysfunction affects the outcomes of newly diagnosed chronic lymphocytic leukemia (CLL). Researchers concluded that patients with liver dysfunction at diagnosis (about 1 in 25 patients) have shorter survival compared to patients with normal liver function.

In CLL, high numbers of abnormal lymphocytes (a type of white blood cell) are found in the blood and bone marrow. They do not fight infection as normal lymphocytes do. These ineffective lymphocytes can also accumulate in lymph nodes, the spleen, and the liver, causing them to swell and affecting their normal function. Whether early liver dysfunction affects the outcome of CLL has not been fully studied. 

The records of 2,336 newly diagnosed CLL patients were analyzed to examine the occurrence and implications of liver dysfunction. All patients underwent a liver function test before receiving first-line therapy. Treatment outcomes were followed for up to 10 years.

3.5% of patients presented with abnormal liver function at the time of diagnosis. Patients with liver dysfunction were significantly more likely to have advanced-stage disease and lower red blood cell counts at diagnosis. No differences in excess body weight or genetic abnormalities due to CLL were noted between patients with and those without liver dysfunction.

A further 236 patients with normal liver function at diagnosis developed liver dysfunction during follow-up. Low red blood cell and platelet (cells involved in clotting) counts and specific genetic abnormalities at diagnosis were predictors of acquired liver dysfunction.  

The average time to first therapy was 7 years for patients with normal and for those with abnormal liver function at diagnosis. Overall survival (time from treatment until death from any cause) for patients with liver dysfunction at diagnosis was 6.6 years. This was significantly shorter compared to patients with normal liver function (11.6 years). Even after adjusting age, gender, disease stage, and type of therapy, mortality risk was 80% higher among patients with liver dysfunction.

This study concluded that liver dysfunction at diagnosis occurs can impact CLL outcomes.