Clonal lymphocytic populations in Philadelphia-negative chronic myeloproliferative disorders: is the T-cell clonality of 'undetermined' significance (TCUS) linked to a worse clinical outcome?
This study examined the clonality of B- and T-cells by PCR in 83 patients with Philadelphia-negative myeloproliferative disorders (Ph-MPD), to investigate its clinical and morphological correlates. Clonal lymphocytic populations were found in 23% of patients (T: n = 20, B: n = 3), with no frequency differences between ET, CIMF and PV. At the presentation, patients with clonal bands were older (58.1+/-13.8 vs 47.5+/-14.6, p = 0.0039), but did not differ in other clinical parameters. After the median follow-up of 21 months they were less likely to be asymptomatic (11.8% vs 41.1%, p = 0.029). The T-cell clonality was the strongest predictor of the symptomatic last follow-up by discriminant function analysis, surpassing the patient's age. This surprising negative prognostic impact of lymphocyte clonality in Ph-MPD may result from this phenomenon to be a better measure of the 'hematopoietic biologic age' than the metrical age itself.
Stój
Anastazja
A
Department of Pathomorphology, Collegium Medicum, Jagiellonian University, Kraków, Poland.
Rudzki
Zbigniew
Z
Piniewska
Danuta
D
Sacha
Tomasz
T
Czekalska
Sylwia
S
Okoń
Krzysztof
K
Stachura
Jerzy
J
D001706:Biopsy; D001853:Bone Marrow / Q000473:pathology; D002908:Chronic Disease; D002999:Clone Cells / Q000473:pathology*; D006801:Humans; D007136:Immunoglobulins / Q000235:genetics; D054438:Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative / Q000145:classification / Q000453:epidemiology / Q000473:pathology* / Q000628:therapy*; D008875:Middle Aged; D009196:Myeloproliferative Disorders / Q000145:classification / Q000453:epidemiology / Q000473:pathology* / Q000628:therapy*; D016692:Receptors, Antigen, T-Cell, gamma-delta / Q000235:genetics; D013601:T-Lymphocytes / Q000145:classification / Q000473:pathology*; D016896:Treatment Outcome
D007136:Immunoglobulins; D016692:Receptors, Antigen, T-Cell, gamma-delta