The importance of assessment the prognostic factors at diagnosis of chronic lymphocytic leukemia
Journal Title: Postępy Nauk Medycznych - Year 2013, Vol 26, Issue 3
Abstract
Patients with chronic lymphocytic leukemia (CLL) are a clinically heterogeneous group of patients, differing in the course of the disease, survival and response to treatment. In order to optimize the treatment strategy and monitoring of patients with CLL a number of predictive parameters is used. The aim of the study was to evaluate the prevalence of clinical factors, hematological, biochemical, and cytogenetic, and immunophentypic of potential prognostic in patients with CLL at diagnosis. In the group of 46 patients, without treatment, led to a diagnosis and/or treatment at the Department of Hematology and Bone Marrow Transplantation in Katowice were evaluated: clinical stage of disease, and basic biochemical parameters were determined, and using flow cytometrymethod CLL cell phenotype and prognostic factors (CD38, CD49d, CD11c, CD54) were tested also. ZAP-70 expression was determined by immunocytochemistry method in cytological preparations. Cytogenetics studies were performed by fluorescence in situ hybridization (FISH). Estimated distribution: del(13) (q14), del(11) (q22-q23), trisomy 12, del(17) (p13.1).<br>In 9% of patients elevated leukocytosis were observed, anemia occurred in 7% and thrombocytopenia in 11%, enlarged peripheral lymph nodes in 74 and 50% of the spleen. The most of the reported patients presented low clinical stage by Binnet (54%). A positive result of the expression of antigens CD38, CD49d, CD11c and CD54 were found in 37, 30, 33 and 70%, respectively. Cytogenetic aberrations were observed as follows: del (13) (q14) – 39%, del (11) (q22-q23) – 13%, trisomy 12 – 11%. Del(17) (p13.1) was observed in 7%. In everyday clinical practice, in addition to investigate the parameters of hematology, clinical chemistry, it seems appropriate determination of prognostic factors evaluated by immunophenotypisation, with particular emphasis on CD38, CD49d and ZAP-70, due to the high prevalence and the general availability of the methods for their determination.
Authors and Affiliations
Joanna Dziaczkowska-Suszek, Małgorzata Krawczyk-Kuliś, Aleksandra Bartkowska-Chrobok, Sławomira Kyrcz-Krzemień
Keywords
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