RESUMEN
Chronic lymphocytic leukemia (CLL) is a clonal malignant disease of B lymphocytes (T lymphocytes are rare) and usually occurs in elderly people. CLL has a highly variable clinical course, with a median survival of 35 to 63 months. In the era of immunochemotherapy, the survival of CLL patients has improved significantly, but most patients still have primary drug resistance and relapse after the treatment. The emergence of Bruton tyrosine kinase inhibitor has completely changed the treatment mode of CLL, making the treatment of CLL into the era of targeted therapy. Ibrutinib combined with CD19 chimeric antigen receptor T-cell has good efficacy and can improve the prognosis of patients.
RESUMEN
Objective:To improve the understanding of chronic lymphoblastic leukemia (CLL) with t(14;18)(q32;q21).Methods:The clinical data of 3 cases diagnosed as CLL with t(14;18)(q32;q21) in the Tianjin KingMed Medical Laboratory from January 2020 to January 2021 were retrospectively analyzed. The clinicopathological data, morphological examination, immunophenotype, cytogenetics and somatic mutation of immunoglobulin heavy chain variable region genes of patients were comprehensively analyzed, and the literature was reviewed.Results:All the 3 patients showed lymphatic proliferative diseases, and their morphological characteristics and immunophenotype were typical characteristics of CLL.Conclusions:The diagnosis of CLL is mainly based on the typical morphology and immunophenotype of tumor cells. The presence of t(14;18) should not be used to exclude the diagnosis of CLL.
RESUMEN
Objective To discuss the relationship betwee n chromosome abnormalities and disease progress and prognosis in chronic lymphocytic leukemia (CLL). Methods The karyotype of 56 patients with CLL were analyzed, and combined probe was applied to do fluorescence in situ hybridization (FISH) detection. Results Conventional cytogenetics detection found abnormal karyotype in 26 cases (46.4 %), by comparing the median overall survival (OS), the normal karyotype group (>31.9 months) and abnormal group (24.0 months) had statistically difference (χ2=6.60, P0.05), the OS of patients with p53 or ATM gene abnormality was significantly shorter than that of normal patients. Compared with the patients without genetic abnormality and with 1, 2 or 3 kinds of gene abnormalities, the patients with 4 kinds of gene abnormalities had minimum median OS. According to the modified installment Rai, the OS rate of low and intermediate risk group was higher than that of low risk group (χ2= 10.61, P< 0.05). According to the modified installment Binet stage,the OS rate of stage C was lower than that of stage B (χ2= 6.60, P< 0.05). Conclusion The prognosis of CLL patients in same risk group is very strong heterogeneity, cytogenetics changes and biological indicator are the important prognostic factors of CLL.