Atypical lymphocyte morphology: an adverse prognostic factor for disease progression in stage A CLL independent of trisomy 12.
We studied 270 patients with Binet stage A chronic lymphocytic leukaemia looking for adverse prognostic factors. In a multivariate analysis the following features were found to be risk factors for disease progression: atypical lymphocyte morphology (defined as either > 10% prolymphocytes or > 15% lymphocytes with cleaved nuclei or lymphoplasmacytoid cells); more than two karyotypic abnormalities; lymphocyte count > 30 x 10(9)/l; lymphocyte doubling time < 1 year; enlargement of one or more lymph node groups. In a univariate analysis the presence of trisomy 12 also correlated with progressive disease, but this was largely a consequence of the association between trisomy 12 and atypical lymphocyte morphology. Atypical lymphocyte morphology is an important prognostic factor in stage A CLL, and one which incurs no additional investigational cost.
Oscier
D G
DG
Department of Haematology, Royal Bournemouth Hospital, London.
Matutes
E
E
Copplestone
A
A
Pickering
R M
RM
Chapman
R
R
Gillingham
R
R
Catovsky
D
D
Hamblin
T J
TJ
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002881:Chromosomes, Human, Pair 12 / Q000235:genetics*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000235:genetics* / Q000473:pathology; D008214:Lymphocytes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D014314:Trisomy