LONG-TERM CLINICAL OUTCOME OF B-CELL CHRONIC LYMPHOCYTIC-LEUKEMIA PATIENTS IN CLINICAL REMISSION PHASE EVALUATED AT PHENOTYPIC LEVEL

This retrospective study aimed to evaluate the long-term prognostic im pact of phenotypic remission in B-cell chronic lymphocytic leukaemia ( CLL) patients who have achieved clinical, haematological and bone-marr ow complete remission (CR) after conventional chemotherapy. The clinic al and phenotypic data of 77 CLL patients in CR with a median follow-u p from CR achievement of 54 months (range 5-127) were analysed. 32 pat ients (42%) displayed a normalized phenotype as evaluated by k:lambda ratio or by CD5(+)/ CD19(+) cell numbers. Patients with normalized phe notype demonstrated a significantly higher incidence of female sex, a lower relapse rate, a trend for higher prevalence of stage A and a low er occurrence of CLL-related deaths. The relapse-free survival of pati ents with normalized phenotype was significantly longer (P = 0.02), wh ereas no difference in overall survival was found between the two grou ps. Interestingly, Binet's stage at diagnosis was highly predictive of the overall survival following CR achievement. From the results of th e present study we conclude that a phenotype normalization at CR obtai ned with conventional chemotherapy indicates a higher probability of a longer CR but it does not translate into prolonged survival. Clinical features at diagnosis, such as stage distribution, are apparently str onger predictors of the final outcome. These results emphasize, howeve r, the need for a routine assessment of the quality of response since this information could be crucial in designing therapeutic strategies for young patients suffering from advanced CLL.