Rai K R, Sawitsky A
Blood Cells. 1987;12(2):327-38.
Recent reports of successfully completed cytogenetic studies using polyclonal B-cell activators demonstrate that trisomy-12 and 14 q+ are the most frequently observed chromosomal abnormalities in B-cell chronic lymphocytic leukemia (CLL). It appears that when trisomy-12 is accompanied by yet another abnormality, the prognosis of patients is uniformly poor. Patients in early stages of CLL retain delayed hypersensitivity reactivity, while those in advanced stages are usually anergic. The lymphocytes from venous blood of patients with CLL appear to retain at least some ability to respond to stimulation with mitogens in early stages, whereas in advanced stages they show no response to mitogens. Serum immunoglobulin levels are normal in the early (0 and I) stages, are markedly decreased in the advanced (III and IV) stages, and are somewhat between these extremes in the intermediate (II) stage of CLL. Prolymphocytic leukemia and prolymphocytoid transformation of CLL are indicators of poor prognosis, while a morphological variant characterized by large granular lymphocyte is associated with good prognosis. At this time it is not possible to ascribe strong prognostic significance to phenotypic features of lymphocytes in B-CLL; however, studies currently in progress may soon provide important insights on this subject. We have reviewed the pertinent literature and we also present a summary of results from our laboratory.
近期有关使用多克隆B细胞激活剂成功完成细胞遗传学研究的报告表明，12三体和14q+是B细胞慢性淋巴细胞白血病（CLL）中最常观察到的染色体异常。似乎当12三体伴有另一种异常时，患者的预后普遍较差。CLL早期患者保留迟发型超敏反应性，而晚期患者通常无反应。CLL患者静脉血中的淋巴细胞在早期似乎至少保留了一些对有丝分裂原刺激的反应能力，而在晚期则对有丝分裂原无反应。血清免疫球蛋白水平在CLL的早期（0期和I期）正常，在晚期（III期和IV期）显著降低，在中期（II期）则介于这两个极端之间。幼淋巴细胞白血病和CLL的幼淋巴细胞样转化是预后不良的指标，而以大颗粒淋巴细胞为特征的形态学变异与良好预后相关。目前尚无法将B-CLL中淋巴细胞的表型特征赋予强大的预后意义；然而，目前正在进行的研究可能很快会在这个问题上提供重要的见解。我们回顾了相关文献，并呈现了我们实验室的结果总结。
