Objective:To study the proportion of smudge cells and prolymphocytic cells in lymphocytes from peripheral blood smear to predict prognosis value of chronic lymphocytic leukemia (CLL). Methods:We counted 200 lymphocyte in each patient’s routine blood smear,and calculated the proportion of smudge cells and prolymphocytic cells in lymphocytes. We detected the expression of ZAP70 or CD38 among CD5+CD19+ cells by flow cytometry. We analyzed the correlation of smudge cells,prolymphocytic cells,ZAP70+ cells and CD38+ cells. Results:In 53 patients with CLL,the median percentage of smudge cell was 24.5% (1%~65%),the median percentage of prolymphocytic cell was 5.3% (1%~51%). Smudge cells were negatively related to prolymphocytic cells (r = -0.317,P = 0.021). The proportion of smudge cells in 11 patients with ZAP70+ was significantly lower than that in patients with ZAP70- (P = -0.046),and the proportion of prolymphocytic cell was higher than that in patients with ZAP70- (P = 0.002),smudge cells proportion was negatively correlated with ZAP70- expression (r = -0.7818,P = 0.004). In 15 patients with CD38+,the proportion of smudge cells was lower than that in patients with CD38-(P = 0.024),and the proportion of prolymphocytic cells was higher than that in patients with CD38-(P < 0.001),the proportion of prolymphocytic cells was positively correlated with ZAP70 or CD38 expression (ZAP70:r = 0.685,P = 0.020;CD38:r = 0.575,P = 0.025). Conclusion:In CLL patients,smudge cells or prolymphocytic cells on peripheral blood smear and expression of ZAP70 and CD38 in peripheral blood were the same. The detection of smudge cells and prolymphocytic cells on peripheral blood smear is simple and easy,it can be used as a prognostic indicator of CLL patients in basic hospital which did not carry out flow cytometry.