Reduced hemoglobin

In CLL, a decrease in the hemoglobin level can be caused not only by bone marrow infiltration with tumor cells with crowding out all the hemopoiesis sprouts, but also autoimmune conflict. An enlarged lymph node, including bronchopulmonary, is not always accompanied by high leukocytosis in the peripheral blood. In the rheographic method of studying pulmonary blood flow, pulsatory vibrations of large vessels are detected. Therefore, these indicators for the diagnosis of leukostasis in the vessels of the lungs and bronchi are not reliable.

Classifying functions: Group1 = -1.21-0.57 * X1-1.62 * X2 + 0.87 * X3 + 1.77 * X4 + 0.74 * X5 + 1.07 * X6 + 0.63 * X7 + 1.05 * X8 + 1.46 * X9. Group 2 = -86.8 + 46.5 * X1 + 41.1 * X2 + 32.2 * X3 + 25.5 * X4 + 39.2 * X5- 9.7 * X6 + 4.7 * X7-2 , 8 * X8 + 1.9 * X9.

The obtained classification functions can be used to assign a patient to group 1 or group 2. For this indicator values ​​obtained from the newly admitted patient, are entered into the classification functions for groups 1 and 2. The classification functions are calculated, and the patient relates to the group for which the calculation gave a greater value.

As an example, here is an extract from the case history No 12368. Patient S., born in 1940. Diagnosis: Chronic lymphocytic leukemia, splenic form, stage C according to the classification of Binet. The diagnosis was made in 2002, death was ascertained in 2006.

Clinical research data from 2005. Peripheral lymph nodes of all groups up to 2 – 3 cm in diameter, soft-elastic consistency. The spleen is significantly enlarged, occupies the entire left half of the abdomen. The lower edge of the liver is palpable 14 cm below the right costal arch. Blood count: hemoglobin – 106 g / l, erythrocytes – 3.3 × 10 12 / l, platelets – 50 × 10 9 / l, leukocytes 150 × 10 9 / l, lymphocytes – 80%, segmented core – 12% , eosinophils – 3%, monocytes – 5%.Immunophenotyping of peripheral blood lymphocytes – CD5 +, CD19 +, CD20 +, CD22 +, CD23 +. Radiographic examination of the chest: mediastinal lymph nodes are not enlarged, the high position of the diaphragm dome. These endobronchial LDF: PM – 23.8 PE, σ – 11.7PE, Kv – 45.1%, Ae – 6.1 PE, An – 3.5 PE, Am – 3 PE, Hell – 2.4PE, Ac – 1.65 PE. When conducting a regional rheography, MOVr (soum) -70 ohm / min, MPKr (soum) – 65 ohm / min.

During the discriminant analysis, the following data was available: leukocytosis> 100 × 10 9 / l (1), PM <50 PE (1), Reduction of Ac <2.5 PE (1), Reduction of Ad <2.5 PE (1 ), relapsing and protracted AML (1), B-symptoms (1), MPKr <50 ohms / min (0), Decrease in hemoglobin <100 g / l (0), increase in bronchopulmonary lymph nodes at CT (0 ).

The following classification functions were calculated: Group 1 = -1.21-0.57 * 1-1.62 * 1 + 0.87 * 1 + 1.77 * 1 + 0.74 * 1 + 1.07 * 1 +0, 63 * 0 + 1.05 * 0 + 1.46 * 0 = 2.19. Group 2 = -86.8 + 46.5 * 1 + 41.1 * 1 + 32.2 * 1 + 25.5 * 1 + 39.2 * 1-9.7 * 1 + 4.7 * 0- 2.8 * 0 + 1.9 * 0 = 88.0.

As can be seen from the calculation results, the value of the classifying function for group 2, equal to 88.0, is greater than the value of the function for group 1. Consequently, the patient was assigned to group 2, the combination of the listed symptoms most likely indicated the presence of leucostasis in the vessels of the lungs and bronchi.

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