Adenosplenomegaly and prognosis in uncomplicated and complicated chronic lymphocytic leukemia. A study of 362 cases.
Presence and size of lymph nodes and spleen, graded from 0 to , in 362 patients with CLL observed from diagnosis were evaluated. Statistical analysis showed a relationship with age, sex, anemia and thrombopenia, leukocytosis, and outlined two different groups: the one without organomegalies , with higher mean age (67 years), female prevalence, and better prognosis; the other with adenosplenomegaly graded ++/ , with lower mean age (57 years), clear male prevalence, and worse prognosis. Survival results were statistically different only between groups 0/+ versus group ++/ . Important chronic diseases were present at diagnosis in approximately 25% of the cases, with a severely reduced survival (median, 27 months), close to that of the cases with anemia and/or thrombopenia (22 months). Therefore it seems that in every prognostic grouping system, complicated cases should be taken into account and grouped with the anemic and/or the thrombopenic ones. The following prognostic groups are proposed: I: low risk: cases without or with adenomegaly and/or splenomegaly + (65% surviving at 100 months); II: intermediate risk: cases with adenomegaly and/or splenomegaly ++/ (median survival, 70 months); III: high risk: cases complicated by chronic diseases, or with anemia and/or thrombopenia (median survival, 25 months).
D000367:Age Factors; D000368:Aged; D000740:Anemia / Q000150:complications; D001772:Blood Cell Count; D005260:Female; D006801:Humans; D007945:Leukemia, Lymphoid / Q000150:complications / Q000401:mortality / Q000473:pathology*; D008198:Lymph Nodes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012306:Risk; D012737:Sex Factors; D013163:Splenomegaly; D013921:Thrombocytopenia / Q000150:complications