Frequency of TP53 Mutation in B-Cell Chronic Lymphocytic Leukaemia and its Association with Lymphocyte Doubling Time.

OBJECTIVE: To determine the frequency of TP53 mutation at diagnosis of B-cell Chronic Lymphocytic Leukaemia (B-CLL) in Pakistani patients, and to investigate whether lymphocyte doubling time (LDT) of less than 1 year could be used as a surrogate marker for TP53 mutation. STUDY DESIGN: A cross-sectional descriptive study. Place and Duration of the Study: Department of Haematology, Liaquat National Hospital, from January 2020 to December 2022. METHODOLOGY: Patients diagnosed with B-CLL based on the criteria set by International Workshop on Chronic Lymphocytic Leukaemia were included in the study. Clinico-haematological parameters were recorded, and TP53 mutation analysis was performed by fluorescence in situ hybridisation. Patients were followed every 3-6 months after diagnosis with the recent complete blood count (CBC) reports to record CBC parameters and calculate LDT. RESULTS: A total of 128 B-CLL cases were evaluated, with a mean age of 62 years. Among these cases, 10 patients (7.8%) tested positive for TP53 mutation, while 118 patients (92.2%) tested negative. During the follow-up period, 26 patients were lost to follow-up, with only one patient from the TP53 positive group. In the TP53 positive group, 55.6% (n=5/9) patients had an LDT of less than 1 year, indicating aggressive disease compared to 30.1% (n=28/93) patients in the negative group (p <0.1). CONCLUSION: TP53 mutations may be associated with shorter LDT, indicating aggressive disease. Further research is needed to fully comprehend the relationship between TP53 mutation and LDT in B-CLL. KEY WORDS: TP53 mutation, B-Cell chronic lymphocytic leukaemia (B-CLL), Lymphocyte doubling time (LDT).

Marked Acanthocytosis Associated With Klipple Trenaunay Syndrom.

Klipple-Trenaunay syndrome (KTS) is an extremely rare congenital vascular disorder with poorly defined incidence and prevalence. We report a case of a patient who presented after road traffic accident with primary complaints of poor wound healing and persistent bleeding from wound site. Discernible presence of arteriovenous malformation and skin hypertrophy since birth lead to the diagnosis of Klipple-Trenaunay syndrome (KTS). There was an incidental finding of acanthocytosis on peripheral film of blood which remained elevated even after clinical improvement of the patient. This case report highlights a close association of marked acanthocytosis of red blood cells and Klipple-Trenaunay syndrome.