Peripheral erythroid precursor and prognosis in chronic granulocytic leukemia

Abstract

Seventy-four consecutive patients with nonblastic chronic granulocytic leukemia (CGL) were observed from diagnosis and retrospectively studied. The patients were segregated into three risk groups according to the staging system proposed by Sokal et al. A significant difference in survival was observed only between Stage I and III (P = 0.01). The prognostic role of other variables, different from those considered in the Sokal et al. equation, was then investigated. Multiple regression analysis of data was made, by forcing into the Cox's regression model the Sokal et al. equation, while allowing the remaining variables to move in and out of the model. Only the presence of peripheral nucleated erythrocytes improved the significance (chi-square improvement = 4.565; P value improvement = 0.033). The evaluation of peripheral erythroid precursors is proposed for further implementation of the staging systems in CGL.

Clinical and histological features retain their prognostic impact under interferon therapy of CML: A pilot study

“…This result implicates that the amount of erythroid cells probably reflects the expansion of the Ph'+ granulocytic cell clone. A number of authors have formerly focused their attention on the occurrence of nucleated red cells in the peripheral blood as important factors of prognosis [1,3,9,11,51]. In several series it has been reported that inclusion of this parameter generated a further implementation of the different staging systems in CML [ 1,11,5 11. This finding could also be demonstrated in our investigation ( Fig.…”

Prognostic impact of bone marrow erythropoietic precursor cells and myelofibrosis at diagnosis of Ph1+ chronic myelogenous leukaemia – a multicentre study on 495 patients

“…Applying a monoclonal antibody directed against glycophorin C and morphometry, a significant reduction of the red cell lineage was found in 27% to 35% of our patients compared with the normal bone marrow. In contrast to erythroblasts of the peripheral blood (Kantarjian et al , 1985, 1990; Levis et al , 1986; Thiele et al , 1993a; Hehlmann et al , 1997a), erythroid precursor cells of the bone marrow have been rarely studied in CML with respect to their predictive property (Thiele et al , 1993b). In an extension of these preliminary data including only a small series, a remarkable association with survival could also be confirmed in this multicentre trial on 495 patients.…”

“…In addition, regarding allogeneic bone marrow transplantation, some published data provide persuasive evidence that pretransplant myelofibrosis might be responsible for a delayed engraftment and, consequently, an unfavourable outcome (Rajantie et al , 1986). Of the other histological bone marrow features that were assumed to exert a prognostic property, nucleated erythroid precursor cells of the bone marrow have been rarely studied with respect to their prognostic impact (Thiele et al , 1993b), although anaemia and erythroblasts in the peripheral blood were repeatedly described as distinctive predictors (Kantarjian et al , 1985, 1990; Levis et al , 1986; The Italian Cooperative Study Group on Chronic Myeloid Leukaemia, 1993; Thiele et al , 1993a; Hehlmann et al , 1997a). In consideration of these inconsistencies surrounding certain aspects of prognostic evaluation in chronic‐phase Ph 1+ CML, the purpose of this clinicopathological study was first to investigate representative pretreatment bone marrow biopsies from different sources in a large number of patients receiving standard treatment regimens.…”

Impact of clinical and morphological variables in classification and regression tree‐based survival (CART) analysis of CML with special emphasis on dynamic features

“…These studies were aimed at distinguishing subgroups of patients with different risks (9)(10)(11)(12)(13)(14)(15)(16). However, these predominantly clinical studies failed to consider morphological parameters of the bone marrow indicative for survival, such as myelofibrosis, megakaryocyte count, presence of pseudo-Gaucher cells or reduction of erythroid precursors (17)(18)(19)(20)(21)(22)(23)(24)(25)(26). So far, features related to cell kinetics or the dynamics of cell turnover have gained little attention in the context of survival data in CML.…”