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New Parameters of Diploid Histogram of Image DNA Cytometry and Newly Characterized Types of the Nucleolar Organizer Region Structures in Defining the Proliferative-Kinetic Index in the Chronic Leukemic Lymphoproliferative Disorders

Objective: To introduce new parameters of diploid histogram of image DNA cytometry, and new types of the nucleolar organizer region (AgNOR) and to validate resulting proliferative kinetic index (PKI) in a prognostic study in patients with the chronic leukemic lymphoproliferative disorders (CLLPD). Study Design. A total of 413 smears of in various tumor mass compartments: bone marrow (BM), peripheral blood (PB) and lymph node (LN) were analyzed in CLLPD as a whole and in the B-chronic lymphocytic leukemia with variants (B-CLL+V) in separate. The analysis of diploid histogram included percentage of cells in peak of DNA histogram, and percentage of cells with lower and higher contents of DNA than cells in peak. The newly types of AgNOR were described: homogeneous, inhomogeneous and annular. Results. The newly introduced parameters of DNA and AgNOR are significant predictors of survival. Based on the most representative AgNOR and DNA characteristics related to survival, the PKI score was calculated. The CLLPD (p=0, 00118) and B-CLL+V (p=0, 03589) patients had a statistically significantly better prognosis when PKI was less than 4. Conclusion. PKI have confirmed the hypothesis that different prognostically subgroups could be identified within the homogeneous groups of neoplasms with relatively low malignancy (CLLPD and B-CLL+V).

chronic lymphoproliferative disorders; chronic lymphocytic leukemia; proliferative kinetic index; image DNA cytometry; nucleolar organizer region

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