ISSN 2997-1036
International Journal of Hematology | Vol. 7, No. 10, October 2016 | pp. 73–80
DOI: 10.46882/2016/IJH/000082
Original Article
Title: Prevalence and clinicopathological characteristics of B-cell prolymphocytic leukemia variations
Names of Authors: G. M. Babalola¹, I. N. Nwosu², K. S. Abubakar³
Authors’ Affiliations: ¹Department of Haematology and Blood Transfusion, Lagos University Teaching Hospital, Lagos, Nigeria; ²Department of Medicine, University of Nigeria, Nsukka, Nigeria; ³Department of Pathology, Bayero University, Kano, Nigeria
Abstract: B-cell prolymphocytic leukemia is an aggressive mature B-cell malignancy requiring precise differentiation from chronic lymphocytic leukemia with increased prolymphocytes. This 5-year retrospective audit investigated the prevalence, morphological features, and immunophenotypic panels of 18 cases of confirmed B-cell prolymphocytic leukemia. Diagnosis was established based on World Health Organization criteria, where circulating prolymphocytes exceeded 55.0% of total lymphocytes. Morphological analysis revealed a classic large blastic outline with a prominent, single, centrally located nucleolus in a mean of 72.4% of lymphoid cells. Multiparameter flow cytometry demonstrated strong surface IgM expression, bright CD20, and bright CD22 co-expression in all 18 cases, while CD5 expression was detected in only 22.2% of the cohort. Deletion 17p13 (TP53 locus) was identified via fluorescence in situ hybridization in 61.1% (11 of 18) of the patients, correlating strongly with primary chemoresistance to initial purine analog-based regimens. The median overall survival was 18.5 months, with advanced clinical stage and TP53 abnormalities predicting poorer outcomes. Comprehensive immunophenotypic and cytogenetic screening is essential to identify this rare, aggressive leukemic variant and guide early targeted therapeutic strategies.
Keywords: B-cell prolymphocytic leukemia, prolymphocytes, flow cytometry, TP53 deletion, immunophenotyping
Manuscript Timeline: Received: July 12, 2016; Revised: August 22, 2016; Accepted: September 10, 2016; Published: October 18, 2016