Prognostic significance of chromosome abnormalities in chronic lymphocytic leukaemia

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Abstract
Summary: Lymphocytes from 33 out of 63 patients with B‐cell chronic lymphocytic leukaemia (B‐CLL) were successfully stimulated for cytogenetic analysis by means of two B‐cell mitogens: pokeweed mitogen and lipopolysaccharide‐B, used after pretreatment of the cells with neuraminidase and galactose oxidase. All patients had abnormal clones in 30‐100% of the cells analysed. Chromosomes more frequently involved were Nos. 1,3, 6,11,12,13 and 14. The most common abnormality was a marker 14q+ (breakpoint 14q32) seen in 17 cases; trisomy 12 was observed in seven cases. A clinical scoring system was used to investigate the correlation of chromosome abnormalities with prognosis. The group with 14q+ was often associated with features of progressive disease, namely; prolymphocytoid or Richter transformation, refractoriness to therapy, high WBC and advanced staging. A significant difference in survival was observed between patients with 14q+ and the rest: median survival from diagnosis being 45 months and over 64 months, respectively (P<0‐05); when survival was calculated from the time of chromosome analysis the values were 8 months and more than 41 months, respectively (P < 0 01). It is suggested that 14q + is acquired during the evolution of CLL and that this development may be a key event in the clinical progression of B‐CLL. Other abnormalities, including trisomy 12, were not found to be associated with a worse prognosis.