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Chronic lymphocytic leukemia with low lymphocyte count

A Batata1, B Shen

  • 1Department of Pathology, Cox Institute, Wright State University School of Medicine, Dayton, Ohio 45429.

Cancer
|May 1, 1993
PubMed
Summary
This summary is machine-generated.

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Chronic lymphocytic leukemia with low absolute lymphocyte count (CLL-LLC) presents similar immunologic markers to typical CLL. Early immunophenotyping is crucial for diagnosing CLL-LLC, which constitutes 6% of B-CLL cases.

Area of Science:

  • Hematology
  • Oncology
  • Immunology

Background:

  • Diagnosis of chronic lymphocytic leukemia (CLL) typically requires an absolute lymphocyte count (ALC) > 5 x 10^9/l.
  • Cases with low ALC (CLL-LLC) are often overlooked and not included in current staging systems.
  • The diagnostic significance of differential lymphocyte counts in CLL-LLC remains underemphasized.

Purpose of the Study:

  • To investigate the immunologic characteristics of CLL-LLC.
  • To compare CLL-LLC with typical CLL using immunophenotyping and cytochemical analysis.
  • To highlight the importance of immunologic investigations for diagnosing CLL-LLC.

Main Methods:

  • Peripheral blood samples from 12 CLL-LLC and 189 typical CLL patients were analyzed.
  • Immunologic evaluation included surface immunoglobulin (SIg), mouse erythrocyte rosettes, CD5, CD19, CD20, CD22, and CD2.

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  • Cytochemical evaluation of tartrate-resistant acid phosphatase (TRAP) was performed.
  • Main Results:

    • CLL-LLC patients (ages 47-84) had ALC from 1.5-4.9 x 10^9/l and 52-93% lymphocytes.
    • CLL-LLC exhibited immunophenotypic similarity to typical CLL, including weak monoclonal SIg, positive CD5, and high CD19/CD20 expression.
    • No statistical differences were found in immunologic markers or SIg isotype distribution between CLL-LLC and typical CLL.

    Conclusions:

    • CLL-LLC accounts for 6% of B-cell CLL and may be missed without immunologic investigation due to low ALC and absence of symptoms.
    • Persistent relative lymphocytosis (≥50%) in individuals over 50 warrants further investigation for CLL via immunophenotyping.
    • Immunophenotyping of peripheral blood lymphocytes and bone marrow examination are essential for diagnosing CLL-LLC.