A clinicopathologic analysis of chronic lymphocytic leukemia.

Sixty consecutive patients with chronic lymphocytic leukemia (CLL) were studied from both a clinical and laboratory standpoint. Hypoimmunoglobulinemia was found in 45% of patients; many of these patients suffered from severe bacterial infections. Second primary malignancies were diagnosed in 20% of patient's; most of these predated the diagnosis of CLL. HLA-B17 typing was found in unexpectedly high frequency in a small group of Coombs'-positive patients. The Rai-staging system was found to be generally useful for determining prognosis of groups of patients, although less useful in any individual patient. Findings relating to surface membrane immunoglobulin-positive (B) and E-rosetting (T) lymphocytes are described. A patient with null-cell CLL is described. All patients with proliferation of gamma heavy-chain-bearing cells were diagnosed in early Rai stages suggesting that this marker may identify a subset of patients who present early and have a good prognosis. These data suggest that lymphocyte marker studies augment the Rai criteria in evaluating prognosis and may eventually be of value to the clinician in evaluating stage of disease and response to treatment.