title: Chronic Lymphocytic Leukemia (B-CLL) and Immunocytoma (LP-IC): Clinical and Prognostic Relevance of this Distinction.
abstract: The Kiel classification of non-Hodgkin lymphomas (NHL) has established chronic lymphocytic leukemia (B-CLL) and immunocytoma (LP-IC) as separate entities of low-grade malignant NHL by morphological and immunohistochemical criteria. The clinical and prognostic relevance of this discrimination was evaluated in a prospective multicenter observation study by the Kiel Lymphoma Study Group. From 1975 to 1980, 430 previously untreated patients with B-CLL (n = 217) and LP-IC (n = 213)a were recruited and followed for up to 14 years. While the age and sex distribution and the incidence of clinical stages were quite similar in both entities major differences between initial manifestations in B-CLL and LP-IC became evident, e.g. in the incidence of bone marrow infiltration (99.5 vs. 86%), peripheral blood lymphocytosis (99.5 vs. 60%), or monoclonal gammopathy (1 vs. 30%). A strictly localized tumor (Ann Arbor stage I/IE) was seen in only 1.5% of the LP-IC patients who were successfully treated by local radiotherapy. In all other patients an expectative-palliative treatment concept was pursued. Long-term survival data analysis revealed significant differences between B-CLL and LP-IC and identified the pseudofollicular in B-CLL and the lymphoplasmacytic in LP-IC as the most favorable histological subtypes. The discriminative prognostic potential of clinical stage (Rai or Binet classification) for B-CLL and LP-IC varied and the pattern of prognostic risk factors obtained by multivariate analysis was not identical. Thus, the morphological distinction between B-CLL and LP-IC correlates with characteristic differences between these entities both in their initial clinical presentation and long-term prognosis.
authors.affiliation: a Kiel Lymphoma Study Group, Germany and Austria.
authors.forename: M
authors.initials: M
authors.lastname: Engelhard
authors.affiliation: a Kiel Lymphoma Study Group, Germany and Austria.
authors.forename: G
authors.initials: G
authors.lastname: Brittinger
authors.affiliation: a Kiel Lymphoma Study Group, Germany and Austria.
authors.forename: R
authors.initials: R
authors.lastname: Heinz
authors.affiliation: a Kiel Lymphoma Study Group, Germany and Austria.
authors.forename: H
authors.initials: H
authors.lastname: Theml
authors.affiliation: a Kiel Lymphoma Study Group, Germany and Austria.
authors.forename: H
authors.initials: H
authors.lastname: Bartels
authors.affiliation: a Kiel Lymphoma Study Group, Germany and Austria.
authors.forename: T
authors.initials: T
authors.lastname: Binder
authors.affiliation: a Kiel Lymphoma Study Group, Germany and Austria.
authors.forename: H H
authors.initials: HH
authors.lastname: Fülle
authors.affiliation: a Kiel Lymphoma Study Group, Germany and Austria.
authors.forename: H
authors.initials: H
authors.lastname: Gerhartz
authors.affiliation: a Kiel Lymphoma Study Group, Germany and Austria.
authors.forename: U
authors.initials: U
authors.lastname: Gunzer
authors.affiliation: a Kiel Lymphoma Study Group, Germany and Austria.
authors.forename: F
authors.initials: F
authors.lastname: Ludwig
authors.affiliation: a Kiel Lymphoma Study Group, Germany and Austria.
authors.forename: W D
authors.initials: WD
authors.lastname: Ludwig
authors.affiliation: a Kiel Lymphoma Study Group, Germany and Austria.
authors.forename: L
authors.initials: L
authors.lastname: Nowicki
authors.affiliation: a Kiel Lymphoma Study Group, Germany and Austria.
authors.forename: J
authors.initials: J
authors.lastname: Oertel
authors.affiliation: a Kiel Lymphoma Study Group, Germany and Austria.
authors.forename: H W
authors.initials: HW
authors.lastname: Pees
authors.affiliation: a Kiel Lymphoma Study Group, Germany and Austria.
authors.forename: H
authors.initials: H
authors.lastname: Pralle
authors.affiliation: a Kiel Lymphoma Study Group, Germany and Austria.
authors.forename: U
authors.initials: U
authors.lastname: Rühl
authors.affiliation: a Kiel Lymphoma Study Group, Germany and Austria.
authors.forename: C V
authors.initials: CV
authors.lastname: Schilling
authors.affiliation: a Kiel Lymphoma Study Group, Germany and Austria.
authors.forename: W
authors.initials: W
authors.lastname: Spann
authors.affiliation: a Kiel Lymphoma Study Group, Germany and Austria.
authors.forename: U
authors.initials: U
authors.lastname: Szeimies
authors.affiliation: a Kiel Lymphoma Study Group, Germany and Austria.
authors.forename: H J
authors.initials: HJ
authors.lastname: Wetzel
authors.affiliation: a Kiel Lymphoma Study Group, Germany and Austria.
authors.forename: T
authors.initials: T
authors.lastname: Zwingers
authors.affiliation: a Kiel Lymphoma Study Group, Germany and Austria.
authors.forename: A C
authors.initials: AC
authors.lastname: Feller
authors.affiliation: a Kiel Lymphoma Study Group, Germany and Austria.
authors.forename: H
authors.initials: H
authors.lastname: Stein
authors.affiliation: a Kiel Lymphoma Study Group, Germany and Austria.
authors.forename: K
authors.initials: K
authors.lastname: Lennert
keywords: Non-Hodgkin lymphoma; chronic lymphocytic leukemia; immunocytoma; low-grade malignant; lymphocytic lymphoma