Clinicopathological features and outcome of chronic lymphocytic leukaemia in Chinese patients.

Chronic lymphocytic leukaemia (CLL) is uncommon in Chinese population and its biology, genetics and treatment outcome in Chinese patients have not been comprehensively investigated. In this study, we studied the clinicopathological features and outcome of 212 Chinese patients with newly diagnosed CLL in Hong Kong and Singapore. The median age at diagnosis was 64 years. The majority of patients presented with early-stage disease (Binet stage A, 56.1%). Del(13)(q14) was the most frequent abnormality (41.7%) detected by fluorescence in situ hybridization (FISH) analysis. Del(17p) and TP53 gene mutations were detected in 7.8% and 8.2% of patients, respectively. MYD88 mutations were found at a higher frequency (11.5%) than expected. CLL with unmutated variable region of the immunoglobulin heavy chain genes (IGHV) occurred in only 31.2% of cases, and was associated with advanced-stage disease (p <0.01) and adverse FISH abnormalities (p<0.01). With a median follow-up of 39 months, the median overall survival (OS) was 108 months. The presence of del(17p) or TP53 mutations was associated with a significantly shorter time to first treatment and an inferior OS (p <0.01). Unmutated IGHV was also associated with a significantly shorter time to treatment (p <0.01). Among patients who required treatment, the median OS and progression-free survival (PFS) were 107 and 23 months, respectively. The presence of del(17p) was associated with a significantly inferior OS and PFS (p <0.01). In summary, Chinese CLL patients had similar genetic aberrations at diagnosis compared with those of Western populations. FISH abnormalities are major factors affecting outcome.

Raised troponin I in Chinese patients with acute pulmonary embolism suggests complicated clinical course and may predict intensive care unit admission.

INTRODUCTION: Acute pulmonary embolism (PE) is an uncommon but potentially fatal disease. Acute right ventricular failure, which can be demonstrated by echocardiography, is known to be an adverse prognostic factor in patients with acute PE. However, this diagnostic test is not always available in emergency departments and it is also an operator-dependent investigation. This study aimed to investigate whether cardiac troponin I (cTnI) levels could predict clinical outcomes in Chinese patients with PE. METHODS: This was a retrospective cohort study performed in a tertiary regional hospital in Hong Kong. For this study, 100 patients who were diagnosed with acute PE between January 1, 2002 and December 31, 2009 were recruited. Information, including demographic data, presenting symptoms and vital signs at presentation, predisposing factors for PE, results of diagnostic procedures and clinical outcomes, was collected from the medical records of these patients. RESULTS: 71% of recruited patients had elevated cTnI levels. High cTnI levels were associated with haemodynamic instability (odds ratio [OR] 5.30, 95% confidence interval [CI] 1.32-27.71; p = 0.019) and complicated clinical course (OR 6.34, 95% CI 1.76-22.9; p = 0.002). CONCLUSION: Elevated cTnI level was associated with a complicated clinical course in patients with acute PE. We suggest that measurements of cTnI levels be used for the early risk stratification of patients with PE in the emergency departments of hospitals.