AgNOR clusters as a parameter of cell kinetics in chronic lymphocytic leukaemia

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AgNOR clusters as a parameter of cell kinetics in chronic lymphocytic leukaemia.

Irene Lorand-Metze and Konradin Metze

Clin Mol Pathol, December 1, 1996; 49(6): M357-M360.

Department of Internal Medicine, Faculty of Medicine, State University of

Campinas, Brazil.

Aims-To study correlations between the pattern of silver stained nucleolar

organiser regions (AgNORs) in chronic lymphocytic leukaemia (CLL) and parameters

of tumour kinetics. To investigate whether quantitation of the AgNOR pattern can

be used to discriminate between patients with stable and progressive

disease.Methods-Peripheral blood smears from 48 patients with CLL, classified as

having either stable or progressive disease (Rai stage III or IV; bulky lymph

nodes or massive splenomegaly; or peripheral lymphocytes >100 x 10(9)/1), were

studied. For each patient, total tumour mass (TTM) and for patients undergoing a

period of observation without treatment, the TTM duplication time (DT) and the

lymphocyte doubling time (LDT) were calculated.Results-Four cell types could be

distinguished according to their AgNOR pattern: (1) cells with a single cluster;

(2) cells with a single compact nucleolus; (3) cells with two compact nucleoli;

and (4) cells with several scattered dots. The percentage of cells with clusters

was the AgNOR parameter which correlated best with TTM and LDT. Correlations

were also seen between the proportion of cells with clusters and age and

haemoglobin concentration. A significant correlation with DT could be detected

only when age was kept constant. Linear discriminant analysis revealed that the

percentage of cells with clusters was the most important prognostic factor. This

alone classified 94% of the patients correctly (jackknive procedure) as either

stable or progressive CLL.Conclusions-The percentage of circulating lymphocytes

with clusters of AgNORs can be used as a parameter of tumour kinetics in CLL and

helps to discriminate between patients with stable and progressive disease. For

practical purposes, a value of more than 13% of cells with clusters is

suggestive of progressive disease.

PMID: 16696103