'Prolymphocytoid' cells in chronic lymphocytic leukaemia and their prognostic significance

The morphology of lymphocytes in blood and bone marrow smears from 103 patients with chronic lymphocytic leukaemia (CLL) was studied. Special attention was paid to the finding of immature cells with the morphological features of prolymphocytes (prolymphocytoid cells -PLC). Subsequently the prognostic significance of these cells was examined. It was found that in 85 cases no PLC were found (Group I); in 8 cases the percentage was less than or equal to 10% (Group II) and in 10 cases the PLC were greater than 10% (Group III). The cases with PLC, especially in group III, fell in advanced stages of the disease (III-IV) and presented with increased lymphocytosis. In 8 patients of group III, who were followed till death, the disease became refractory to any treatment and the survival was short. We suggest that 'prolymphocytoid' transformation is a bad prognostic sign in CLL.