title: The bone-marrow infiltration pattern in B-cell chronic lymphocytic leukemia is not an important prognostic factor. Danish CLL Study Group.
abstract: In a multicentre study of 635 consecutive newly diagnosed patients with B-CLL, the histological bone marrow (BM) specimens were reviewed independently by each of 3 pathologists and found evaluable for BM infiltration pattern in 575 patients, 404 of whom had a CD5+, mainly FMC7-, faint surface-membrane immunoglobulin (SIg) fluorescence-intensity ppenotype. In these 404 patients the following BM infiltration patterns were found: mixed nodular-interstitial (30%), moderate interstitial (44%), heavy interstitial (20%) and diffuse packed (6%). In univariate survival analysis, significant differences were found according to BM pattern (p < 0.05), the presence of nodules being a favorable prognostic sign. In multivariate survival analysis in a model including age, clinical stage, BM pattern, BM lymphocytosis, WBC and sex, only age and stage but not BM pattern or BM lymphocytosis had independent prognostic significance. In stage A, progression-free survival was significantly longer in patients with nodular than in patients with non-nodular bone-marrow pattern. The overall survival of these patients, however, did not differ, possibly owing to the prompt and prolonged treatment given to most patients at the time of progression to stage B or C. We conclude that in CD5+, SIg(faint), mainly FMC7-B-CLL, bone-marrow histology may predict unstable disease in early clinical stage but is not important for treatment decisions, when these are based on clinical stage.
authors.affiliation: Department of Hematology, Rigshospitalet University Hospital, Copenhagen, Denmark.
authors.forename: C H
authors.initials: CH
authors.lastname: Geisler
authors.forename: K
authors.initials: K
authors.lastname: Hou-Jensen
authors.forename: O M
authors.initials: OM
authors.lastname: Jensen
authors.forename: N
authors.initials: N
authors.lastname: Tinggaard-Pedersen
authors.forename: M M
authors.initials: MM
authors.lastname: Hansen
authors.forename: N E
authors.initials: NE
authors.lastname: Hansen
authors.forename: M
authors.initials: M
authors.lastname: Holm
authors.forename: B E
authors.initials: BE
authors.lastname: Christensen
authors.forename: A
authors.initials: A
authors.lastname: Drivsholm
authors.forename: J B
authors.initials: JB
authors.lastname: Nielsen
authors.forename: K
authors.initials: K
authors.lastname: Thorling
authors.forename: E
authors.initials: E
authors.lastname: Andersen
authors.forename: J K
authors.initials: JK
authors.lastname: Larsen
authors.forename: P K
authors.initials: PK
authors.lastname: Anderson
mesh_terms: D000367:Age Factors; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001853:Bone Marrow / Q000473:pathology; D018956:CD5 Antigens / Q000032:analysis; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D011947:Receptors, Antigen, B-Cell / Q000032:analysis; D016019:Survival Analysis
chemical_list: D018956:CD5 Antigens; D011947:Receptors, Antigen, B-Cell