What Does Atypical Chronic Lymphocytic Leukemia Really Mean? A Retrospective Morphological and Immunophenotypic Study

Giovanni D’Arena, Candida Vitale, Giuseppe Pietrantuono, Oreste Villani, Giovanna Mansueto, Fiorella D’Auria, Francesca D'Auria, Teodora Statuto, Simona D’Agostino, Stefano D'Agostino, Rosalaura Sabetta, Angela Tarasco, Angelina Tarasco, Idanna Innocenti, Francesco Autore, Alberto Fresa, Luciana Valvano, Annamaria Tomasso, Lorenzo Cafaro, Daniela LamorteLuca Laurenti

Risultato della ricerca: Contributo in rivistaArticolo in rivista

Abstract

Atypical chronic lymphocytic leukemia (CLL) is still defined according to morphological criteria. However, deviance from the typical surface immunological profile suggests an atypical immunological-based CLL. A large cohort of patients with CLL was retrospectively evaluated aiming at assessing morphological (FAB criteria), immunophenotypical (two or more discordances from the typical profile), and clinical–biological features of atypical CLL. Compared to typical cases, morphologically atypical CLL showed a greater percentage of unmutated IgVH and CD38 positivity, and a higher expression of CD20. Immunophenotypically atypical CLL was characterized by more advanced clinical stages, higher expression of CD20, higher rate of FMC7, CD79b and CD49d positivity, and by an intermediate–high expression of membrane surface immunoglobulin, compared to typical cases. When patients were categorized based on immunophenotypic and morphologic concordance or discordance, no difference emerged. Finally, morphological features better discriminated patients’ prognosis in terms of time-to-first treatment, while concordant atypical cases showed overall a worse prognosis. Discordant cases by immunophenotype and/or morphology did not identify specific prognostic groups. Whether—in the era of molecular markers used as prognostic indicators—it does make sense to focus on morphology and immunophenotype features in CLL is still matter of debate needing further research.
Lingua originaleEnglish
pagine (da-a)N/A-N/A
RivistaCancers
Volume16
DOI
Stato di pubblicazionePubblicato - 2024

Keywords

  • atypical
  • chronic lymphocytic leukemia
  • flow cytometry
  • immunophenotype
  • morphology
  • prognosis

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