| Expanded and highly active proliferation centers identify a histological subtype of chronic lymphocytic leukemia ("accelerated" chronic lymphocytic leukemia) with aggressive clinical behavior. | |
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MedLine Citation:
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PMID: 20378568 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Background The concept of "accelerated" chronic lymphocytic leukemia (CLL) is frequently used by both pathologists and clinicians. However, neither histological criteria to define this form of CLL nor its clinical correlates and prognostic impact have been formally defined in large series of patients. DESIGN AND METHODS: Tissue biopsies from 100 patients with CLL were analyzed for the size of proliferation centers (PCs) and their proliferation rate as assessed by mitosis count and Ki-67 immunostaining. Histological patterns were correlated with main clinico-biological features and outcome. RESULTS: The suspicion of disease transformation was the main reason to carry out tissue biopsy, which was performed at a median time of 14 months (range, 0 to 204) from CLL diagnosis. The biopsy showed histological transformation to diffuse large B-cell lymphoma (DLBCL-t) in 22 cases. In the remaining 78 patients, the presence of expanded PCs (broader than a 20x field) and high proliferation rate (either >2.4 mitosis/PC or Ki-67>40%/PC) predicted poor outcome and were selected to define a highly proliferative group. Thus, 23 patients with either expanded PCs or high proliferation rate were considered as having "accelerated" CLL. These patients displayed particular features, including higher serum LDH levels and more frequently elevated ZAP-70 than "non-accelerated" cases. Median survival from biopsy of patients with "non-accelerated" CLL, "accelerated" CLL and DLBCL-t was 76, 34, and 4.3 months, respectively (p<0.001). Conclusions The presence of expanded PCs and/or highly active PCs identifies a group of patients with "accelerated" CLL characterized by an aggressive clinical behavior. |
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Authors:
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Eva Giné; Antoni Martinez; Neus Villamor; Armando López-Guillermo; Mireia Camos; Daniel Martinez; Jordi Esteve; Xavier Calvo; Ana Muntañola; Pau Abrisqueta; Maria Rozman; Ciril Rozman; Francesc Bosch; Elias Campo; Emili Montserrat |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2010-4-7 |
Journal Detail:
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Title: Haematologica Volume: - ISSN: 1592-8721 ISO Abbreviation: - Publication Date: 2010 Apr |
Date Detail:
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Created Date: 2010-4-9 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0417435 Medline TA: Haematologica Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Institute of Hematology and Oncology, Hospital Clinic, Barcelona, Spain. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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