Bone marrow biopsy and clinical staging in chronic lymphocytic leukemia

We have examined the value of bone marrow biopsy histopathology in chronic lymphocytic leukemia (CLL). Cases involving a pattern of interstitial, nodular, or mixed interstitial plus nodular infiltration of lymphocytes were clinically similar and manifested a more benign course. These patterns correlated with the clinical Stages 0, I, and II. However, cases involving a pattern of diffuse or mixed diffuse plus nodular infiltration of lymphocytes formed a clinical group with a more rapidly progressive course and these patterns correlated with clinical Stages III and IV. Other measurements, e.g., calculation of the percentage of lymphatic tissue in the bone marrow biopsy specimen and of the ratio of the percentage of lymphatic tissue in marrow to the peripheral blood lymphocyte count, were found to be cumbersome to perform and of no additional value to clinical staging in prognosis indication in CLL.