Naslov
More on clinical heterogeneity in B-CLL. The importance of tumor mass distribution.
(More on clinical heterogeneity in B-CLL. The importance of tumor mass distribution)

Autori
Jakšić, Ozren ; Planinc-Peraica, Ana ; Marić, Kristina ; Brugiatelli, M. ; Jakšić, Branimir

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, ostalo

Izvornik
Abstract Book / Gahrton, G. - : ISH, 1997, 106-106

Skup
Meeting of the International Society of Haematology

Mjesto i datum
Stockholm, Švedska, 30.08.1997. - 04.09.1997

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
chronic lymphocytic leukemia; prognosis

Sažetak
An intriguing and highly variable clinical characteristic of B-CLL is distribution of tumor mass. In majority of cases there is a simultaneous involvement of blood & marrow and lymphoid organ compartment, with variable extent of compartment involvement, ranging from purely leukemic to more lymphoma like. This study was performed to evaluate clinical relevance of tumor mass distribution in B-CLL with two main objectives: 1) to introduce an unbiased assessment of tumor mass distribution to all patients, and to assess its relationship to other well established clinical parameters; 2) to evaluate the impact of new parameter on prognosis. 755 B-CLL patients with median age of 63 years and 64.1% males were analyzed. Tumor mass distribution was evaluated by TTM score system (Jaksic et al., 1981). In this system, the score in blood and marrow (TM1) is compared to sum of scores in lymphoid organs (TM2 - lymph nodes and TM3 - spleen). Leukemic distribution was defined by TM1 greater than TM2+TM3, and lymphoma like by TM1 lesser than TM2+TM3. 78.8% of patients were classified as leukemic and 21.2% as lymphoma like with no difference with respect to age and sex. Since TTM system has characteristics of continuous quantitative variable it allows unbiased assessment of whole spectrum ranging from purely leukemic (Rai 0) to more solid tumor, or lymphoma like distribution. Prognosis was significantly better for leukemia distribution (p=0.0000) in women, but not in men. In multivariate analysis tumor mass distribution was strongest predictor of prognosis in women. Moreover, in bad prognostic group with bone marrow failure (Rai 3+4), the subset of leukemic distribution female patients had a significantly better prognosis (p=0.028). We conclude that introduced parameter, being quantitative, unbiased and easily assessed in all patients, should be recommended for clinical use. In women, it shows an independent and strong prognostic power. It may reflect more fundamental biological difference concerning the type of the disease and warrants further attention.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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