New parameters of diploid histogram of image DNA cytometry and newly characterized types of nucleolar organizer region structures in defining the proliferative-kinetic index in chronic leukemic lymphoproliferative disorders.

OBJECTIVE To introduce new parameters of diploid histogram of image DNA cytometry and new types of silver-stained nucleolar organizer regions (AgNORs) and to validate resulting proliferative-kinetic index (PKI) in a prognostic study of patients with chronic leukemic lymphoproliferative disorders (CLLPD). STUDY DESIGN A total of 413 smears of from various tumor mass compartments-bone marrow, peripheral blood and lymph node-were analyzed in CLLPD as a whole, as well as separately in the B-chronic lymphocytic leukemia with variants (B-CLL+V). The analysis of the diploid histogram included percentage of cells at the peak of the DNA histogram and percentage of cells with lower and higher contents of DNA than cells at the peak. The new types of AgNORs were described as homogeneous, inhomogeneous and annular. RESULTS The newly introduced parameters of DNA and AgNOR are significant predictors of survival. Based on the most representative AgNOR and DNA characteristics related to survival, the PKI score was calculated. The CLLPD and B-CLL+V patients had a statistically significantly better prognosis when PKI was < 4. CONCLUSION PKIs have confirmed the hypothesis that different prognostic subgroups could be identified within the homogeneous groups of neoplasms with relatively low malignancy (CLLPD and B-CLL+V).