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B‐cell chronic lymphocytic leukaemia: Prognostic value of the immunophenotype and the clinico‐haematological features
Author(s) -
Orfao Alberto,
Gonzalez Marcos,
Fernando Miguel J. San,
Rios Agustin,
Canizo M. Consuelo,
Hernandez Jose,
Maricato M. Lourdes,
Borrasca Antonio Lopez
Publication year - 1989
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.2830310105
Subject(s) - medicine , immunophenotyping , bone marrow , lymphocyte , pathology , univariate analysis , peripheral blood lymphocyte , gastroenterology , cd20 , peripheral blood cell , immunology , multivariate analysis , lymphoma , antigen
Sixty‐two previously untreated patients with B‐cell chronic lymphocytic leukaemia were analysed to study the prognostic value of both the immunologic phenotype and the clinicobiologic characteristics. Univariate studies showed that none of the immunological markers analysed, sheep‐rosette, mouse‐rosette, slg, and HLA/DR, CD20, FMC7, CD5, and CD9 antigens, had a significant influence on survival. On the other hand, several clinical and haematological characteristics were identified as being associated with survival: 1) clinical features—presence of lymphadenopathies ( P < .05) and hepatomegaly and/or splenomegaly ( P < .04); 2) haematologic parameters—presence of anaemia and/or thrombopenia ( P < .05), the absolute peripheral blood lymphocyte count ( P < .03), and the presence of hypogammaglobulinemia ( P < .08); 3) biochemical parameters—serum uric acid ( P < .03); and 4) bone marrow histopathological features—biopsy pattern ( P < .04) and the percentage of lymphocytes in bone marrow aspirate ( P < .03). Both the Rai staging and the International Workshop on CLL staging systems were effective in identifying groups of patients with significantly different prognoses ( P < .05). Multivariate regression analysis demonstrated that the combination of three clinicopathologic characteristics (bone marrow histopathologic pattern, absolute peripheral blood lymphocyte count, and the presence or not of hypogammaglobulinaemia) had the strongest predictive relationship with survival time. In summary, our findings show that the clinicobiological and anatomopathologic parameters have much more prognostic relevance than the immunological markers analysed in the present study.