Further characterization of morphologically defined typical and atypical CLL: a clinical, immunophenotypic, cytogenetic and prognostic study on 390 cases |
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Authors: | Arnold Criel Gregor Verhoef Robert Vlietinck Cristina Mecucci Johan Billiet Lucienne Michaux Peter Meeus ries Louwagie Angeline Van Orshoven Achiel Van Hoof Mark Boogaerts Herman Van den Berghe & Chris De Wolf-Peeters |
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Affiliation: | Departments of Haematology A.Z. St Jan Brugge; K.U. Leuven; Department of Pathology; Centre for Human Genetics, K.U. Leuven, Belgium |
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Abstract: | We analysed a group of 390 patients, diagnosed with chronic lymphocytic leukaemia (CLL). Cases were subclassified as morphologically typical and atypical CLL according to the criteria of the FAB proposal. Typical CLL cases were mostly diagnosed at a low-risk stage (Binet A/Rai 0), required no immediate treatment and expected a long survival; atypical CLL cases mostly presented at a more advanced risk stage (Binet B/Rai I–II), usually required immediate treatment and their survival was shorter. Moreover, clinical staging was of prognostic significance in typical but not in atypical cases. In typical CLL, del(11q) was the most common chromosomal abnormality (21%) whereas in atypical CLL trisomy 12 was found in about 65% of the cases documented with an abnormal karyotype. Although chromosomal abnormalities were associated with a poor survival in typical CLL, they are of no prognostic significance in atypical CLL. Based on these data, we conclude that subtyping CLL by morphology enables the identification of two groups of cases, each characterized by a specific clinical presentation, different cytogenetic abnormalities and prognostic parameters. We speculate that these two groups may represent two related, but different, diseases with different prognostic parameters and a different survival. |
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Keywords: | typical CLL atypical CLL clinical characteristics immunophenotype cytogenetics |
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