THE RELEVANCE OF CYTOLOGICAL STUDIES AND KI-67 REACTIVITY TO THE CLINICAL COURSE OF CHRONIC LYMPHOCYTIC-LEUKEMIA

The aim of the study was to investigate whether the growth fraction an d cytology of peripheral blood and lymphoid tissues relate to response to treatment in CLL. Growth fraction was assessed using the monoclona l antibody Ki-67. Peripheral blood (PB) films and lymph node and splee n touch imprints or aspirates were examined in 35 patients (pts) with CLL: smouldering CLL (4 pts) (no therapy), progressive CLL but respons ive to chlorambucil and cyclophosphamide (15 pts) and resistant CLL(16 pts). Cytological studies of lymphoid tissues showed that pts with re sistant CLL had an increased proportion of prolymphocytes and blasts a nd the highest Ki-67 expression (mean 6,6%). PB morphology was not dif ferent between the groups of resistant and responsive CLL. However, th e cases with resistant CLL showed a higher percentage of Ki-67 positiv e PB cells (p < 0,05). Four pts with indolent CLL had typical CLL morp hology in the PB and the lowest numbers of prolymphocytes and blasts w ith Ki-67 positive cells in lymphoid tissues.