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Diagnostic role and prognostic significance of a simplified immunophenotypic classification of mature B cell chronic lymphoid leukemias

Leukemia volume 17, pages 125–132 (2003)Cite this article

Abstract

We verified the diagnostic and prognostic role of a simplified immunophenotypic classification (IC) in a series of 258 patients (M/F: 1.4; median age: 64 years; median follow-up: 64 months; 75 deaths) with mature B cell lymphoid leukemias (MBC-LL) for whom no histopathological diagnosis was available because of minimal or no lymph node involvement. The IC was based on the reactivity of three pivotal immunophenotypic markers: CD5, CD23 and SIg intensity. On the basis of different expression patterns, we identified four diagnostic clusters (C) characterized by distinct clinico-biological features and different prognoses: C1 (149 patients) identified most classical B cell chronic lymphocytic leukemias (CLL-type cluster; SIgdim/CD5+/CD23+); C2, 38 patients whose clinico-hematological characteristics were intermediate between C1 and C3 (CLL-variant cluster; SIgbright/CD5+/CD23+/−or SIgdim/CD5−/−/CD23 indifferent); C3 (16 patients) most situations consistent with mantle cell lymphoma in leukemic phase (MCL-type cluster; SIgbright/CD5+/CD23−); and C4, 55 cases, most of whom were consistent with leukemic phase lymphoplasmacytic/splenic marginal zone lymphomas (LP/S-type cluster; SIgbright/CD5−/+/CD23 indifferent). At univariate survival analysis, prognosis worsened from C1 to C4, C2 and C3 (P = 0.0001), and this was maintained at multivariate analysis (P = 0.006), together with CD11c expression (P = 0.0043), age at diagnosis (cut-off 70 years; P = 0.0008) and platelet count (cut-off 140 × 109/l; P = 0.0034). Besides recognising the two well-known situations of classic B-CLL and MCL, our IC identified situations with distinct prognostic and/or clinical behaviors.

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Acknowledgements

This work was supported by a grant (Ricerca Corrente) from the Italian Ministry of Health to Ospedale Maggiore IRCCS, Milan, Italy, and from the Associazione Italiana Ricerca sul Cancro (to AN).

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Authors and Affiliations

  1. Dipartimento di Ematologia, Unità Operativa Ematologia 1, Ospedale Maggiore, IRCCS, Milan, Italy

    L Cro, M Colombi, M Goldaniga, A Neri, D Intini, A Cortelezzi, A T Maiolo & L Baldini

  2. Divisione di Medicina I, Ospedale ‘Fatebenefratelli e Oftalmico’, Milan, Italy

    A Guffanti

  3. Centro di Epidemiologia Ospedale Maggiore, IRCCS, Milan, Italy

    B Cesana

  4. Istituto di Anatomia ed Istologia Patologica, Ospedale S Paolo, Milan, Italy

    M G Grimoldi & C Patriarca

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Cro, L., Guffanti, A., Colombi, M. et al. Diagnostic role and prognostic significance of a simplified immunophenotypic classification of mature B cell chronic lymphoid leukemias. Leukemia 17, 125–132 (2003). https://doi.org/10.1038/sj.leu.2402737

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