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

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 less than 0.002), older age, low percentage T-cells of blood lymphocytes (P less than 0.01), low hemoglobin count, advanced Binet stage, male sex, and high lymphocyte count (P less than 0.05). A therapy-demanding disease was predicted by cytogenetic data (extra chromosome 12, and complex karyotypes [P less than 0.001]), high DxS-induced CLL-cell proliferation (P less than 0.001), high frequency of cytogenetically abnormal metaphases, and advanced Rai and Binet stages (P less than 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.