Immunologic and cytogenetic studies improve prognosis prediction in chronic B-lymphocytic leukemia a multivariate analysis of 24 variables

Abstract

Sixty patients with chronic B-lymphocytic leukemia (CLL) were studied. The prognosis predictions achieved from clinical and hematologic status, cytogenetic karyotype, immune phenotype, and cellular proliferative responses in vitro were studied by Cox's multivariate analysis. Indicators of poor survival were high dextran sulphate (DxS)-induced CLL-cell proliferation in vitro (P < 0.002), older age, low percentage T-cells of blood lymphocytes (P < 0.01), low hemoglobin count, advanced Binet stage, male sex, and high lymphocyte count (P < 0.05). A therapy-demanding disease was predicted by cytogenetic data (extra chromosome 12, and complex karyotypes [P < 0.001]), high DxS-induced CLL-cell proliferation (P < 0.001), high frequency of cytogenetically abnormal metaphases, and advanced Rai and Binet stages (P < 0.01). The best combinations of parameters included the cytogenetic variables, the DxS-induced CLL-cell proliferation, the relative T-cell number, and the Binet stage. Thus, results from immunologic and cytogenetic studies seem to be helpful in the prediction of prognosis.Cancer 58:688-693, 1986.