Salomon-Nguyen F, Valensi F, Merle-Beral H, Flandrin G
Laboratoire d'Hématologie, Hôpital Necker, Paris, France.
Leuk Lymphoma. 1995 Feb;16(5-6):445-50. doi: 10.3109/10428199509054432.
B CLL is a monoclonal proliferation of lymphocytes which express the CD5 antigen (CD5+ CLL). Rare exceptions (less than 10%) are CD5-, as are the majority of B PLL. We have studied the clinical, cytological and immunophenotypic characteristics of a series of 12 CD5-CLL and have established a score which allows the distinction between CD5+ CLL, CD5- CLL and PLL. Among the CD5- CLL, there were significantly more cases with advanced stage (Rai and Binet) and splenomegaly. The cytological study found more mixed CLL according to FAB classification (more prolymphocytes). There were significantly more CD23-, FMC7+, SIg strong positive cases. A score from 0 to 6 was established based on clinical, cytological and immunophenotypic criteria. Typical CD5+ CLL was scored 0, score 6 corresponded to typical PLL. There were significantly more higher scores amongst CD5- CLL. It therefore appears that CD5- CLLs share certain features with B PLL. The use of this scoring system will allow determination of prognosis within these different categories, thus identifying groups which require specific therapy.
B细胞慢性淋巴细胞白血病是一种表达CD5抗原的淋巴细胞的单克隆增殖（CD5+慢性淋巴细胞白血病）。罕见的例外情况（少于10%）是CD5阴性，大多数B细胞幼淋巴细胞白血病也是如此。我们研究了一系列12例CD5阴性慢性淋巴细胞白血病的临床、细胞学和免疫表型特征，并建立了一个评分系统，该系统可区分CD5+慢性淋巴细胞白血病、CD5阴性慢性淋巴细胞白血病和幼淋巴细胞白血病。在CD5阴性慢性淋巴细胞白血病中，晚期（Rai和Binet分期）和脾肿大的病例明显更多。细胞学研究发现，根据FAB分类，混合性慢性淋巴细胞白血病更多（幼淋巴细胞更多）。CD23阴性、FMC7阳性、表面免疫球蛋白强阳性的病例明显更多。根据临床、细胞学和免疫表型标准建立了一个从0到6的评分系统。典型的CD5+慢性淋巴细胞白血病评分为0，评分为6对应典型的幼淋巴细胞白血病。CD5阴性慢性淋巴细胞白血病中高分的病例明显更多。因此，CD5阴性慢性淋巴细胞白血病似乎与B细胞幼淋巴细胞白血病有某些共同特征。使用这个评分系统将有助于确定这些不同类别疾病的预后，从而识别出需要特殊治疗的群体。
