The Effect of T-Lymphocyte Subgroups at Diagnosis on the Prognosis of Chronic Lymphocytic Leukemia

Introduction: Changes in the number and functional capacity of T lymphocytes have been reported in chronic lymphocytic leukemia (CLL) patients. The aim of this study was to examine the prognostic significance of T-lymphocyte subgroups in CLL patients.

Eighty-three previously untreated patients were retrospectively enrolled and flow cytometry results at diagnosis were examined. No difference was found in T-lymphocyte parameters according to age, gender, and disease stage.

The CD4 and CD7 percentages, CD4/MBC (malignant B cell), CD8/MBC, and CD7/MBC values at diagnosis were significantly lower in patients with a progressive disease. T-lymphocyte percentages were significantly lower in deceased patients. In the univariate regression model, T-lymphocyte percentages, T-lymphocyte/MBC ratios, HLA-DR+ percentage, Rai stage (intermediate + high risk), Binet stage (B+C), and beta-2 microglobulin level had significant effects on both progression-free survival (PFS) and overall survival (OS); treatment status (yes) had a significant effect only on PFS, while age at diagnosis (≥65 years) had a significant effect only on OS. In the multivariate regression model, Rai stage, CD7/MBC ratio, and treatment status (yes) had a significant effect on PFS; Rai stage and CD8/MBC ratio had a significant effect on OS.

Lower T-lymphocyte/MBC ratios at diagnosis could be a marker for higher risk of CLL progression.