A polycentric study ON CD5 negative chronic B cell leukemias

Introduction: We retrospectively reviewed a large group of CD5 negative chronic B-cell lymphoid leukemias (B-CLL), a group of disorders relatively uncommon, poorly described, heterogeneous from a biologic, cyto-morphologic and clinical point of view, and whose histo-pathological definition is often missing for absence of lymph adenopathy. Methods: 156 patients affected by CD5-CD10 negative B-CLL (median age 66; 39-86), were evaluated for clinico-hematological features at diagnosis, follow-up and overall survival; variables related to prognosis were identified. Hairy cell leukemias and large cell lymphomas in leukemic phase were excluded. Results: Median follow-up was 51 months (range 12-216). 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. Patients without organ involvement had a borderline significant better survival. 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). Conclusions: This retrospective study describes the clinical features and the variables related to evolution in a large cohort of patients with CD5 negative chronic B-cell lymphoid leukemias.