[Prognostic relevancy of histomorphological bone marrow findings in chronic lymphocytic leukemia (CLL)]

Punctures of the pelvic crest made in 45 patients with CLL (25 men, 20 women, mean age 58.7 years) were classified according to the type of lymphatic bone-marrow infiltrations which can be identified histomorphologically. Four different types were distinguished: 1. interstitial type (lymphatic infiltration of bone-marrow tracts, with lipocytes being present) - 11 cases 2. nodular type (nodular infiltration, free bone-marrow tracts) - 5 cases 3. mixed type (combination of interstitial and nodular type) - 11 cases 4. diffuse type (original haematopoiesis and fat cells have been displaced, type A: purely diffuse type; type B: diffuse + nodular) - 18 cases The statistical analysis of survival curves reveals significant differences in the probability for survival to be met with in types with morphologically limited bone-marrow infiltration in the sense of a proceeding deterioration of prognosis in the following order: interstitial, nodular, mixed, and diffuse type. In addition, a statistically significant correlation existing between the non-diffuse infiltration types and clinical early stages (RAI 0 to II) on the one hand, and the diffuse type and clinical late stages (RAI III and IV) on the other hand, could be identified. In the course of CLL the different types of lymphatic bone-marrow infiltration apparently reflect different degrees of lymphocyte accumulation or proliferation respectively. Because of their significance the histomorphological bone-marrow findings should be included in the therapy planning for CLL.