Prognostic significance of immunoglobulin phenotype in B cell chronic lymphocytic leukemia

Abstract

Seventy-six consecutive untreated patients with B cell chronic lymphocytic leukemia (B-CLL) and classified according to Binet's staging system were studied at the clinical presentation. Several immunologic parameters (number of total and T circulating lymphocytes and their surface membrane immunoglobulin [Smlg] phenotypes and levels of serum Ig) were evaluated with the aim of identifying a biologic marker of prognostic relevance. In this series of persons, Binet staging confirmed its usefulness as a prognostic index (P less than .001). With regard to Smlg, they were mu-type in 41 cases (53.9%), mu- type plus delta-type in 29 cases (38.2%), alpha-type in one case, and not detectable in five cases. No correlations were found between clinical stage and immunoglobulin phenotype, although all but one patient in stage C showed mu-type Smlg alone. On analyzing the survival curves of our patients according to different Smlg phenotypes, we found that patients with only mu-type Smlg had a poorer prognosis (P less than .05) than those with mu-type plus delta-type; this difference was even more significant (P less than .01) in patients in stage A, whereas there were no statistical differences in those in stages B and C. Because the appearance of surface heavy chain of delta-type could be an expression of cell maturation, these results suggest that in B-CLL the presence of phenotypically more mature leukemic cells may correlate with better clinical prognosis, particularly in the early phase of the disease.

Immune Phenotype and Prognosis in Chronic B‐Lymphocytic Leukaemia and Leukaemic Immunocytoma

“…However, when subdivided, the patient groups were small and since the overall survival was good, the prognostic differences were of low significance. In agreement with some recent data on "CLL" (7,8) and lymphocytic lymphomas (17, 181, the p phenotype indicated a poorer prognosis than a pa coexpression. The best prognosis was found in patients with the gamma phenotype.…”

“…However, this finding has not been confirmed, although several reports on the prognosis of immunophenotyped "CLL" have been published. The prognostic value of heavy chain phenotyping is also unclear; a better prognosis associated with p than pta phenotype has been claimed (61, as well as the reverse (7,8).…”

B‐cell chronic lymphocytic leukaemia stage 0. An immunophenotypic study of 66 cases and comparison with B small cell lymphomas*

“…In the literature, the lymphocytes of B-CLL are usually reported to be HLA-DR, EmR, SIg (weakly) CD5, CD19, CD20, CD21, CD23 positive and CD35, CD10, CD38 negative (2,(19)(20)(21)(22)(23)(24). However, in some cases no SIg (13,20,(25)(26)(27) or no CD5 antigen were detected (13,21,28,29). The occurrence of some antigens such as CDlO and CD38 is controversial.…”

Differential expression of LFA‐1 alpha molecule in clinical stages of chronic B‐lymphocytic leukemia patients

“…Different expression of LFA-1 alpha in the various stages of B-CLL might be explained in two ways. First, LFA-1 alpha expression depends on maturational stages; it is unlikely that the absence of LFA-1 represents a differentiation-dependent character, since this molecule has a wide distribution on hematopoietic cells at various maturational stages (3,5) and since different stages of B-cell differentiation, defined by surface IgM and IgD expression (l), are equally distributed in our groups of patients.…”