Abstract
Background and Objectives. Chronic lymphocytic leukemia (CLL) is characterized by clinical, immunophenotypic and morphologic heterogeneity. The morphologic pattern of CLL lymphocytes at diagnosis has been associated with likelihood of different prognoses, while its prognostic significance at the time of disease progression is uncertain. Design and Methods. In 69 previously untreated patients with advanced CLL the morphology of peripheral blood (PB) lymphocytes was retrospectively analyzed prior to therapy with fludarabine (FD: 25 mg/m2 × 5 consecutive days every 4 weeks) and prednisone (P: 40 mg/m2 × 5 consecutive days every 4 weeks). Two groups of patients were identified: the first one characterized by typical CLL morphology (T) and ≤11% of atypical lymphocytes, and the second one characterized by >11% of atypical lymphocytes (A). The second group was further subdivided into a group characterized by prolymphocyte prevalence (Ap) and into a group characterized by mixed cell morphology (Amc), with a prevalence of large-sized lymphocytes and/or small, cleaved lymphocytes and/or lymphoplasmocytoid cells with or without shaped nucleus. Results. Forty-two patients (61%) showed a T morphology and 27 (39%) an A morphology. The latter group included 14 patients with an Ap morphology and 13 with an Amc morphology. Two thirds of patients with A morphology showed an immunophenotypic score of 3-4. No significant differences in the distribution of clinical features prior to therapy were observed within the three morphologic groups (T, Ap, Amc), except for a higher lymphocyte count in the Ap group (p55 years) and CLL duration (≤12 vs >12 months) emerged as significant and independent prognostic factors of survival probability. Interpretation and Conclusions. The results of this study indicate that about one third of CLL patients with advanced disease have an atypical morphology and that about two thirds of patients with A morphology also show a low immunophenotypic score. The morphologic pattern at the time of progression does not allow identification of prognostic subgroups of patients with different response rates to first line therapy with FD + P.
| Original language | English |
|---|---|
| Pages (from-to) | 602-608 |
| Number of pages | 7 |
| Journal | Haematologica |
| Volume | 87 |
| Issue number | 6 |
| Publication status | Published - 2002 |
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Keywords
- Chronic lymphocytic leukemia
- Fludarabine
- Morphology
- Prednisone
ASJC Scopus subject areas
- Hematology
Cite this
Prognostic significance of lymphocyte morphology in patients with advanced chronic lymphocytic leukemia treated with first line therapy of fludarabine + prednisone. / Mauro, Francesca Romana; Gentile, Massimo; Mancini, Francesca; Giannarelli, Diana; Guarini, Anna; De Propriis, Maria Stefania; Cerretti, Raffaella; Foa, Robin.
In: Haematologica, Vol. 87, No. 6, 2002, p. 602-608.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Prognostic significance of lymphocyte morphology in patients with advanced chronic lymphocytic leukemia treated with first line therapy of fludarabine + prednisone
AU - Mauro, Francesca Romana
AU - Gentile, Massimo
AU - Mancini, Francesca
AU - Giannarelli, Diana
AU - Guarini, Anna
AU - De Propriis, Maria Stefania
AU - Cerretti, Raffaella
AU - Foa, Robin
PY - 2002
Y1 - 2002
N2 - Background and Objectives. Chronic lymphocytic leukemia (CLL) is characterized by clinical, immunophenotypic and morphologic heterogeneity. The morphologic pattern of CLL lymphocytes at diagnosis has been associated with likelihood of different prognoses, while its prognostic significance at the time of disease progression is uncertain. Design and Methods. In 69 previously untreated patients with advanced CLL the morphology of peripheral blood (PB) lymphocytes was retrospectively analyzed prior to therapy with fludarabine (FD: 25 mg/m2 × 5 consecutive days every 4 weeks) and prednisone (P: 40 mg/m2 × 5 consecutive days every 4 weeks). Two groups of patients were identified: the first one characterized by typical CLL morphology (T) and ≤11% of atypical lymphocytes, and the second one characterized by >11% of atypical lymphocytes (A). The second group was further subdivided into a group characterized by prolymphocyte prevalence (Ap) and into a group characterized by mixed cell morphology (Amc), with a prevalence of large-sized lymphocytes and/or small, cleaved lymphocytes and/or lymphoplasmocytoid cells with or without shaped nucleus. Results. Forty-two patients (61%) showed a T morphology and 27 (39%) an A morphology. The latter group included 14 patients with an Ap morphology and 13 with an Amc morphology. Two thirds of patients with A morphology showed an immunophenotypic score of 3-4. No significant differences in the distribution of clinical features prior to therapy were observed within the three morphologic groups (T, Ap, Amc), except for a higher lymphocyte count in the Ap group (p55 years) and CLL duration (≤12 vs >12 months) emerged as significant and independent prognostic factors of survival probability. Interpretation and Conclusions. The results of this study indicate that about one third of CLL patients with advanced disease have an atypical morphology and that about two thirds of patients with A morphology also show a low immunophenotypic score. The morphologic pattern at the time of progression does not allow identification of prognostic subgroups of patients with different response rates to first line therapy with FD + P.
AB - Background and Objectives. Chronic lymphocytic leukemia (CLL) is characterized by clinical, immunophenotypic and morphologic heterogeneity. The morphologic pattern of CLL lymphocytes at diagnosis has been associated with likelihood of different prognoses, while its prognostic significance at the time of disease progression is uncertain. Design and Methods. In 69 previously untreated patients with advanced CLL the morphology of peripheral blood (PB) lymphocytes was retrospectively analyzed prior to therapy with fludarabine (FD: 25 mg/m2 × 5 consecutive days every 4 weeks) and prednisone (P: 40 mg/m2 × 5 consecutive days every 4 weeks). Two groups of patients were identified: the first one characterized by typical CLL morphology (T) and ≤11% of atypical lymphocytes, and the second one characterized by >11% of atypical lymphocytes (A). The second group was further subdivided into a group characterized by prolymphocyte prevalence (Ap) and into a group characterized by mixed cell morphology (Amc), with a prevalence of large-sized lymphocytes and/or small, cleaved lymphocytes and/or lymphoplasmocytoid cells with or without shaped nucleus. Results. Forty-two patients (61%) showed a T morphology and 27 (39%) an A morphology. The latter group included 14 patients with an Ap morphology and 13 with an Amc morphology. Two thirds of patients with A morphology showed an immunophenotypic score of 3-4. No significant differences in the distribution of clinical features prior to therapy were observed within the three morphologic groups (T, Ap, Amc), except for a higher lymphocyte count in the Ap group (p55 years) and CLL duration (≤12 vs >12 months) emerged as significant and independent prognostic factors of survival probability. Interpretation and Conclusions. The results of this study indicate that about one third of CLL patients with advanced disease have an atypical morphology and that about two thirds of patients with A morphology also show a low immunophenotypic score. The morphologic pattern at the time of progression does not allow identification of prognostic subgroups of patients with different response rates to first line therapy with FD + P.
KW - Chronic lymphocytic leukemia
KW - Fludarabine
KW - Morphology
KW - Prednisone
UR - http://www.scopus.com/inward/record.url?scp=0036285643&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0036285643&partnerID=8YFLogxK
M3 - Article
C2 - 12031916
AN - SCOPUS:0036285643
VL - 87
SP - 602
EP - 608
JO - Haematologica
JF - Haematologica
SN - 0390-6078
IS - 6
ER -