Pangalis G A, Boussiotis V A, Kittas C
1st Department of Internal Medicine, University of Athens, School of Medicine, Greece.
Nouv Rev Fr Hematol (1978). 1988;30(5-6):373-5.
Previous studies have shown that the pattern of bone marrow (bm) involvement in B-CLL patients is the single most important prognostic factor. In the present study we analyse the disease progression observed in 45 out of 150 untreated stages A and B, B-CLL patients in relation to their pattern of bm involvement. The mean treatment free period was 45 months (10-130). The distribution of bm patterns and disease progression in our series was as follows: in stage A, Bm patterns diffuse in 24 cases (21.8%); in stage B: in 21 cases (52.5%). Disease progression from stage A to stage B or C and from stage B to stage C was found 50% of the A and B-diffuse patients as compared to 10% of the A and B-nondiffuse. The mean period during which this progression occurred was 18 months for the stages A and B with a diffuse pattern and 59 months for the stages A and B with a nondiffuse pattern. No differences could be observed in the nondiffuse group when our patients were analysed on the basis of nodular, interstitial and mixed pattern of bm involvement. All progressed patients required therapy. These findings support our previous observations, and present further evidence that in B-CLL patients with a diffuse pattern of bm disease at diagnosis, treatment should be initiated independently of their clinical stage.
既往研究表明，骨髓（bm）受累模式是B细胞慢性淋巴细胞白血病（B-CLL）患者最重要的单一预后因素。在本研究中，我们分析了150例未经治疗的A期和B期B-CLL患者中45例的疾病进展情况与其bm受累模式的关系。平均无治疗期为45个月（10 - 130个月）。我们系列研究中bm模式和疾病进展的分布如下：A期，24例（21.8%）bm模式为弥漫性；B期，21例（52.5%）。A期和B期弥漫性患者中从A期进展至B期或C期以及从B期进展至C期的比例为50%，而A期和B期非弥漫性患者的这一比例为10%。A期和B期弥漫性模式下发生这种进展的平均时间为18个月，A期和B期非弥漫性模式下为59个月。当根据bm受累的结节性、间质型和混合型模式分析我们的患者时，在非弥漫性组中未观察到差异。所有进展患者均需要治疗。这些发现支持了我们之前的观察结果，并进一步证明，对于诊断时bm疾病为弥漫性模式的B-CLL患者，应独立于其临床分期启动治疗。
