CD5 negative chronic B cell leukemias : a polycentric retrospective study

CD5 negative chronic B-cell lymphoid leukemias (B-CLL) are disorders relatively uncommon, biologically, cyto-morphologically and clinically heterogeneous; moreover histo-pathological definition is often missing for absence of lymph adenopathy. We here describe a retrospectively reviewed large group of these situations. We have evaluated 156 patients affected by CD5-CD10 negative B-CLL (median age 66; 39-86) for clinico-hematological features at diagnosis, follow-up, overall survival and variables related to prognosis were identified. Hairy cell leukemias and large cell lymphomas in leukemic phase were excluded from the study. Median follow-up was 51 months (range 12-216) and overall survival at 3 and 5 yrs was 87% and 76%; 50 patients needed therapy at diagnosis and 40 during follow-up (3-117 months). Bulky disease, B symptoms, anemia (Hb <11g/dl), albumin and LDH levels and lymphocytosis degree significantly related with treatment starting at diagnosis. A borderline significant better survival was observed for patients without organ involvement. At multivariate analysis, LDH levels (P=0.001) and age >60 yrs (P=0.007) were significantly related to overall survival, and LDH (P<0.001), haemoglobin (P=0.007) and systemic clinical presentation (P=0.002) to time to failure (defined as need of therapy for the indolent cases and relapse/progression for treated cases). In conclusions we retrospectively describe the clinical features and the variables related to evolution in a large group of patients with CD5 negative chronic B-cell lymphoid leukemias.