Medicina (Buenos Aires)
versión On-line ISSN 1669-9106
SARMIENTO, Marcela A. et al. Evolution of chronic lymphocytic leukemia: Predictive value of immunophenotype, sCD23 and morphology. Medicina (B. Aires) [online]. 2002, vol.62, n.4, pp. 305-312. ISSN 1669-9106.
Some prognostic factors are useful in chronic lymphocytic leukemia (CLL): lymphocyte doubling time, clinical stage and bone marrow pattern infiltration, while others, such as the percentage of CD38+ cells, are under study and require confirmation. The objective of this study was to evaluate whether there is an association between morphology, lymphocyte immunophenotype, soluble CD23 (sCD23) and progression free survival (PFS). A total of 36 non-treated patients were enrolled. We analysed prospectively: morphology (typical, mixed and PL-CLL); immunophenotypic profile (Matutes score); sCD23 plasma levels; clinical stage; lymphocyte doubling time; b2microglobulin and karyotype abnormalities. Disease progression (need of treatment, progression to advanced stages, development of bulky organomegaly) and death related to disease were considered as events. Md of follow-up 24 mo. Results: Stage 0: 11/36, PFS 80%; I: 10/36 PFS 90%; II: 13/36; III and IV: 2/36. SLE > II PFS 37%. p= 0.023. Lymphocyte doubling time <12mo. 7/31; >12mo. 24/31. PFS 28% vs. 80% p<0.001. Karyotype: normal 13/28, abnormal 15/28. PFS 92% vs. 54% p=0.053. Trisomy 12: positive 7/30, negative 23/30, PFS 66% vs. 65%. b2 microglobulin: normal 9/35; high 26/35. PFS 100% vs. 53% p=0.006. sCD23 < 350 UI/ml: 15/32; > 350 UI/ml: 17/32. PFS 92% vs. 53% p=0.005. Immunophenotype: Score 5: 15/36, Score 4: 19/36, PFS 64%. Score 3: 2/36. p=0.516. Morphology: typical 17/35, mixed 17/35, PFS 81% vs. 57%, p=0.099. PL-CLL 1/35. Conclusions: sCD23 was suitable to predict PFS, specially useful for early stages without additional markers of active disease. Morphology (excluding PL-CLL) and immunophenotype, two common tools, were not useful for the study purpose.
Palabras clave : Chronic lymphocytic leukemia; Prognosis factors.