Prognostic significance of immunoglobulin phenotype in B cell chronic
lymphocytic leukemia
L Baldini, R Mozzana, A Cortelezzi, A Neri, F Radaelli, B Cesana, AT Maiolo and EE Polli
Seventy-six consecutive untreated patients with B cell chronic lymphocytic
leukemia (B-CLL) and classified according to Binet's staging system were
studied at the clinical presentation. Several immunologic parameters
(number of total and T circulating lymphocytes and their surface membrane
immunoglobulin [Smlg] phenotypes and levels of serum Ig) were evaluated
with the aim of identifying a biologic marker of prognostic relevance. In
this series of persons, Binet staging confirmed its usefulness as a
prognostic index (P less than .001). With regard to Smlg, they were mu-type
in 41 cases (53.9%), mu- type plus delta-type in 29 cases (38.2%),
alpha-type in one case, and not detectable in five cases. No correlations
were found between clinical stage and immunoglobulin phenotype, although
all but one patient in stage C showed mu-type Smlg alone. On analyzing the
survival curves of our patients according to different Smlg phenotypes, we
found that patients with only mu-type Smlg had a poorer prognosis (P less
than .05) than those with mu-type plus delta-type; this difference was even
more significant (P less than .01) in patients in stage A, whereas there
were no statistical differences in those in stages B and C. Because the
appearance of surface heavy chain of delta-type could be an expression of
cell maturation, these results suggest that in B-CLL the presence of
phenotypically more mature leukemic cells may correlate with better
clinical prognosis, particularly in the early phase of the disease.
Volume 65,
Issue 2,
pp. 340-344,
02/01/1985
Copyright © 1985 by The American Society of Hematology
