Prognostic value of B‐cell mitogen‐induced and spontaneous thymidine uptakein vitroin chronic B‐lymphocytic leukaemia cells

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Abstract
Summary: Blood lymphocytes from 50 patients with chronic B‐lymphocytic leukaemia (B‐CLL) were culturedin vitrowith and without the polyclonal B‐cell activators (PBA) dextran sulphate (DxS), lipopolysaccharide fromE. coli(LPS), and Epstein Barr virus (EBV). Patients with blood lymphocytes that showed a high spontaneous or PBA‐induced3H‐thymidine uptake in 4 d cultures had a significantly shorter therapy‐free survival than patients whose lymphocytes showed a low thymidine uptake. The DxS‐induced cellular thymidine uptake was the most powerful predictor of prognosis. Eighteen patients with leukaemic cells responding to DxS stimulation had a median therapy‐free survival of 17 months and a probability of 5 year therapy‐free survival of 120 months and >0.7, respectively (log rank,P<0.0001). A multivariate Cox's regression analysis revealed that the DxS‐induced leukaemic cell response was of greater prognostic importance than clinical features such as blood counts and staging according to Rai and Binet. Therefore PBA‐induced leukaemic cell thymidine uptake seems valuable in the prediction of prognosis in B‐CLL.