[Prognostic factors in chronic lymphatic leukemia]

The analysis of our case histories aims at verifying if the immunological phenotype of the leukaemic lymphocyte B, essential diagnostic element, can have prognostic meaning and integrate the known methods of staging. We tested peripheral blood and samples of bone marrow at the cytofluorimeter with techniques of immunofluorescence. We considered the density of the sIg, lymphocytic doubling time (LDT), clusters of designation 23 (CD23), as immunological marker of activation, we also documented a relationship between these indicators and the classic clinical stage. We observed that the chronic lymphocytic leukaemia (CLL) in the stage B and C have generally sIg at high density, correlated to a short time of lymphocytic doubling, and that in the group with a low risk (stage A) the low density of sIg is correlated with a long time of doubling, index of the growth of tumoral bulk. The activation marker (CD23) shows a positive prognostic meaning, as it is more expressed in CLL at a low density of sIg and present in larger quantity in the initial clinical stage. We defined a classic immunophenotypic pattern for the CLL-B with positivity of CD5, sIg at a low density, Ag of activation highly positive related to a history of favourable disease; while an immunologic structure with CD5 negativity, less activated and more differentiated phenotype (CD23 low expression, high density sIg) seems to define a more severe prognosis.