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Further characterization of morphologically defined typical and atypical CLL: a clinical, immunophenotypic, cytogenetic and prognostic study on 390 cases
Author(s) -
Criel Arnold,
Verhoef Gregor,
Vlietinck Robert,
Mecucci Cristina,
Billiet Johan,
Michaux Lucienne,
Meeus Peter,
Louwagie Andries,
Van Orshoven Angeline,
Van Hoof Achiel,
Boogaerts Mark,
Van den Berghe Herman,
De WolfPeeters Chris
Publication year - 1997
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1046/j.1365-2141.1997.402686.x
Subject(s) - chronic lymphocytic leukemia , stage (stratigraphy) , karyotype , medicine , trisomy , clinical significance , oncology , pathology , immunophenotyping , abnormality , cytogenetics , subtyping , immunology , biology , leukemia , chromosome , antigen , genetics , paleontology , psychiatry , gene , computer science , programming language
We analysed a group of 390 patients, diagnosed with chronic lymphocytic leukaemia (CLL). Cases were subclassified as morphologically typical and atypical CLL according to the criteria of the FAB proposal. Typical CLL cases were mostly diagnosed at a low‐risk stage (Binet A/Rai 0), required no immediate treatment and expected a long survival; atypical CLL cases mostly presented at a more advanced risk stage (Binet B/Rai I–II), usually required immediate treatment and their survival was shorter. Moreover, clinical staging was of prognostic significance in typical but not in atypical cases. In typical CLL, del(11q) was the most common chromosomal abnormality (21%) whereas in atypical CLL trisomy 12 was found in about 65% of the cases documented with an abnormal karyotype. Although chromosomal abnormalities were associated with a poor survival in typical CLL, they are of no prognostic significance in atypical CLL. Based on these data, we conclude that subtyping CLL by morphology enables the identification of two groups of cases, each characterized by a specific clinical presentation, different cytogenetic abnormalities and prognostic parameters. We speculate that these two groups may represent two related, but different, diseases with different prognostic parameters and a different survival.