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Marta Masternak,1 Bartosz Puła,2 Joanna Knap,1 Anna Waszczuk-Gajda,3 Joanna Drozd-Sokołowska,3 Kamil Wdowiak,4 Sebastian Grosicki,5 Izabela Kozłowska,6 Marta Kaźmierczak,6 Anna Łabędź,7 Łukasz Szukalski,8 Kamil Wiśniewski,2 Edyta Subocz,9 Janusz Hałka,10 Agnieszka Szymczyk,11 Marek Hus,12 Krzysztof Jamroziak,2 Krzysztof Giannopoulos13 1Department of Experimental Hematooncology, Medical University of Lublin, Lublin, Poland; 2Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland; 3Department of Hematology, Oncology and Internal Diseases, Medical University of Warsaw, Warsaw, Poland; 4Department of Internal Medicine and Oncological Chemotherapy, Silesian Medical University, Katowice, Poland; 5Department of Hematology and Cancer Prevention in Chorzow, Faculty of Health Sciences in Bytom, Silesian Medical University, Katowice, Poland; 6Department of Hematology and Cancer Prevention, Municipal Hospital in Chorzów, Chorzów, Poland; 7Department of Hematology, Rydrygier’s Hospital in Cracow, Cracow, Poland; 8Department of Hematology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Toruń, Poland; 9Department of Hematology, Military Institute of Medicine, Warsaw, Poland; Clinical Department of Hematology, Independent Public Healthcare Centre of the Ministry of Internal Affairs and Administration with Warmia-Mazury Region’s Oncology Centre in Olsztyn, Olsztyn, Poland; 10Clinical Department of Hematology, Independent Public Healthcare Centre of the Ministry of Internal Affairs and Administration with Warmia-Mazury Region’s Oncology Centre in Olsztyn, Olsztyn, Poland; 11Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland; Hematology Department, St John’s Cancer Center, Lublin, Poland; 12Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland; 13Department of Experimental Hematooncology, Medical University of Lublin, Lublin, Poland; Hematology Department, St John’s Cancer Center, Lublin, PolandCorrespondence: Krzysztof Giannopoulos Tel +48 81448 6632Fax +48 81448 6634Email krzysztof.giannopoulos@gmail.comPurpose: Mean platelet volume (MPV) is a readily accessible and commonly tested hematological indicator. Recent studies revealed a significant impact of MPV on the course and prognosis of many diseases, including some types of cancer, as well as on the incidence of atrial fibrillation and bleeding. The study aimed to perform a retrospective analysis of MPV in terms of time to first treatment (TTFT) and to determine its prognostic value in the group of patients with chronic lymphocytic leukemia (CLL). Moreover, the study includes a retrospective analysis of platelet parameters in patients treated with ibrutinib concerning bleeding and atrial fibrillation.Patients and Methods: The study included 523 patients with CLL, for 344 the most important cytogenetic aberrations were reported. The Mann–Whitney, Kruskal–Wallis, Kaplan–Meier, chi-squared, log‑rank tests and multivariate Cox proportional hazard regression model were used to analyze collected data.Results: The receiver operating characteristic curve analysis was performed to identify optimal cut-off value for MPV. The analysis of survival curves showed that in the group of patients with higher values of MPV TTFT was significantly longer than in the group with lower MPV (17.9 vs 36 months, p=0.0015, cut-off value for MPV= 10.4 fl). In multivariate Cox proportional hazard regression model low MPV, the presence of del11q and del13q provided independent prognostic value for TTFT (HR=0.69, 95%-CI, 0.5293 to 0.9081; p=0.0078; HR=1.76, 95%-CI, 1.3000 to 2.3882, p=0.0003, HR=0.74, 95%-Cl, 0.5674 to 0.9588, p=0.0229, respectively). In the group treated with ibrutinib, 59 patients had no significant correlation between MPV level and the incidence of therapy complications, although in the group of patients with low MPV there was a tendency for more frequent occurrence of atrial fibrillation (p=0.259).Conclusion: Low MPV values are associated with unfavorable prognosis and might represent a novel, independent prognostic factor in CLL.Keywords: MPV, chronic lymphocytic leukemia, TTFT