PROGNOSTIC VALUE OF BONE-MARROW HISTOLOGY IN CHRONIC LYMPHOCYTIC-LEUKEMIA - A STUDY OF 335 UNTREATED CASES FROM A SINGLE INSTITUTION

Background and Methods. A significant correlation between bone marrow (BM) histology, survival and disease progression (DP) probability has been observed by several authors in chronic lymphocytic leukemia (CLL) . The prognostic value of BM histologic patterns on survival and disea se progression probability was investigated in 335 B-CLL patients. Res ults. Actuarial survival probability estimated by univariate analysis proved to be significantly influenced by stage (p<0.0001), BM histolog y (p=0.01), and by the following parameters: anemia (p=0.0005), spleno megaly (p<0.001), CLL-related symptoms (p<0.01), thrombocytopenia (p<0 .01), number of involved nodal areas (p=0.01) and peripheral lymphocyt e count over 30x 10(9)/L (p<0.05). In this series we did not detect a discriminating prognostic effect for BM histology within the individua l stages. Cox multivariate regression analysis failed to demonstrate a significant value for BM histology, while stage and anemia emerged as the best prognostic variables. Actuarial DP free probability in 294 u ntreated patients with A and B stages was significantly related to sta ge (p<0.00001) and to BM pattern (p=0.01). Conclusions. Despite the cl ear correlation between the D pattern of BM involvement and advanced a nd early progressive disease, we were unable to demonstrate an indepen dent prognostic value for BM histology. These findings suggest that st age emerged as the best predictive factor of survival probability in o ur B-CLL patients.