TY - JOUR
T1 - The bone-marrow infiltration pattern in B-cell chronic lymphocytic leukemia is not an important prognostic factor
AU - Geisler, C. H.
AU - Hou-Jensen, K.
AU - Jensen, O. Myhre
AU - Tinggaard-Pedersen, N.
AU - Hansen, M. Mørk
AU - Christensen, B. Egelund
AU - Drivsholm, A.
AU - Nielsen, J. Boye
AU - Thorling, K.
AU - Andersen, P. Kragh
PY - 1996
Y1 - 1996
N2 - 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 phenotype. 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.
AB - 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 phenotype. 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.
KW - B-CLL
KW - bone-marrow histology
KW - clinical stage
KW - immunophenotype
KW - prognosis
UR - http://www.scopus.com/inward/record.url?scp=10544237684&partnerID=8YFLogxK
U2 - 10.1111/j.1600-0609.1996.tb01380.x
DO - 10.1111/j.1600-0609.1996.tb01380.x
M3 - Journal article
C2 - 8982292
AN - SCOPUS:10544237684
VL - 57
SP - 292
EP - 300
JO - Scandinavian Journal of Haematology
JF - Scandinavian Journal of Haematology
SN - 0902-4441
IS - 4
ER -