SPLENIC LYMPHOMA WITH VILLOUS LYMPHOCYTES - CLINICAL PRESENTATION, BIOLOGY AND PROGNOSTIC FACTORS IN A SERIES OF 100 PATIENTS

The diagnosis of splenic lymphoma with villous lymphocytes (SLVL) was assessed by a panel of cytologists in a series of 100 patients. Clinic al and biological characteristics were analysed in relation to prognos is. SLVL is a chronic B-cell lymphoproliferative disorder characterize d by splenomegaly and the presence, in peripheral blood, of lymphocyte s with 'villous' projections, The cytological diagnosis can be difficu lt in patients without an absolute lymphocytosis which was observed in 24% of cases. B-ceIls expressed CD19(+), CD20(+), CD22+, CD24(+) and DBA44(+), whereas the expression of CD5, CD10 and CD25 was usually neg ative. SLVL is a disease of the elderly with a relatively benign clini cal course. In the present series the 5-year overall survival was 78%, Deaths in 15 patients were related to disease progression or treatmen t (nine cases), Patients with a leucocyte count >30 x 10(9)/l or lymph ocyte count <4 x 10(9)/l or initially treated with chemotherapy had si gnificantly (P < 0.001) lower overall survival than other patients. Fr om these findings, treatment abstention should be considered in patien ts with favourable prognostic factors; on the other hand, the efficacy of conventional chemotherapy remains to be evaluated in patients with unfavourable prognostic factors.