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Proliferative and kinetics parameters in patients with chronic lymphocytic leukemia and low total tumor mass

Chronic lymphocytic leukemia (CLL) is characterized by low proliferative activity and an indolent low-grade clinical disease course. The clinical stages and other parameters used to date have been unable to identify patients at a high risk of disease progression. Therefore, additional parameters have been identified allowing a more accurate prediction of the prognosis of CLL patients. The aim of the study was to find new morphometric, proliferative and/or kinetic parameters in different tumor mass compartments, i.e. bone marrow, peripheral blood and lymph node, which would be able to predict benefit of early therapeutic approach in early stages of the disease. In 47 CLL untreated patients, with low total tumor mass (TTM<9), tumor doubling time (DTM) and lymphocyte doubling time (DTL) has been calculated. The results showed that lymphatic cells contained mainly small homogeneous AgNOR-e without inhomogeneous or anullar types, and a smaller percentage of cells in S-phase cell cycle, if the DTL and DTM were less than 12 months. Significant image parameters correlating with DTM were found in the lymphoid cells of bone marrow, peripheral blood and lymph nodes ; those correlating with DTL were mostly in the lymphoid cells of peripheral blood, less in lymph node, and very rarely in bone marrow. The morphometric characteristics of homogeneous, inhomogeneous and annular AgNOR, and characteristics of diploid histogram have confirmed the hypothesis that prognostically unfavorable and favorable subgroups could be identified and the course of the disease predicted even within the groups of neoplasms of relatively low malignancy.

chronic lymphocytic leukemia; low tumor mass; DTM; DTL; image analysis

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