[Prognostic significance of cytologic and histomorphologic changes in bone marrow in the treatment of patients with chronic lymphocytic leukemia].

In the aim of establishing the prognosis of chronic lymphocytic leukemia (HLL) in relation to the severeness and course of the disease, during the course of treatment of the patients, two parameters were followed prior to therapy and one year following conducted therapy regarding the morphological changes of lymphocytes in bone marrow specimens and peripheral blood samples and the type of cell infiltration in the bone marrow by means of histomorphological examination. The obtained results point to the fact that progression of illness can be expected also in those patients who are in a milder clinical stadium (stadium A), in the cases when we find more than 20% of atypical lymphocyte forms (prolymphocytes and forms with nucleus aberrations) in the peripheral blood and in the bone marrow, as well as in the cases with a diffuse type of bone marrow infiltration. Such forms should be checked more often. At the same time application of therapy is suggested right after the diagnosis is set, even though the patient may be in the early clinical stadium of the disease, as well as the decision about aggressive treatment.