engleski

Proliferative Kinetic Index Of Chronic Lymphoproliferative Disorders

The clinical and morphological picture of the leukemic types of chronic lymphoproliferative disorders (CLLPD) shows considerable heterogeneity. Due to the unpredictable course of the leukemic types of chronic lymphoproliferative disorders (CLLPD), the clinical stages and other parameters used to date have been unable to identify patients at a high risk of disease progression. Therefore, the aim of the study was to find new proliferative and/or kinetic parameters in different tumor mass compartments: bone marrow (BM), peripheral blood (PB) and lymph node (LN), which would be able to predict survival and disease progression, in order to define the proliferative kinetic index (PKI). Patients and methods: A total of 657 smears of BM (236), LN (275) and PB (146) have been analyzed. The analysis consisted of morphometric characteristics of the nucleolar organization region (AgNOR), and image cytometry (ICM), performed on a SFORM PC (VAMSTEC, Zagreb). Results. The new parameters of modified analysis of diploid histogram and the newly characterized types of AgNORs (homogeneous, inhomogeneous, and annular), yielded a statistically significant correlation, and were additionally found to play a role in the survival. Based on the most representative AgNOR and DNA characteristics (related to survival) in various tumor mass compartments, the PKI score was calculated for the CLLPD population as a whole and for B-CLL+V in separate. Both group had a statistically significantly better prognosis when PKI was less than 4. Conclusion: The PKI score has confirmed the hypothesis that prognostically unfavorable/favorable subgroups could be identified and the course of the disease predicted even within the groups of neoplasms of relatively low malignancy such as CLLPD.

Image DNA cytometry; AgNOR; chronic lymphoproliferative disorders; proliferative kinetic index

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