PATHOMORPHOLOGICAL ANALYSIS OF TREPANOBIOPTATES IN CHRONIC MYELOID LEUKEMIA AND CHRONIC LYMPHOCYTIC LEUKEMIA: ASSESSMENT OF THE PROGNOSTIC VALUE OF MYELOFIBROSIS WHEN COMPARED WITH CLINICAL DATA

The aim of the study was to study the relationship between the qualitative and quantitative characteristics of myelofibrosis and the clinical manifestations of chronic myeloid leukemia and chronic lymphocytic leukemia. Material and methods. A complex pathomorphological study of ilium bone trepanobioptates and a complex clinical-laboratory and instrumental examination of 154 patients with chronic myeloid leukemia and chronic lymphocytic leukemia were performed. Results. In patients in the chronic phase of chronic myeloid leukemia in the onset of the disease and with a loss of response to chemotherapy, the largest area of the spleen was detected with pronounced myelofibrosis, the smallest - in the absence of myelofibrosis. In patients in the onset or relapse of chronic lymphocytic leukemia, splenomegaly, hepatomegaly and generalized lymphadenopathy are most common in patients with myelofibrosis compared to patients without myelofibrosis. The expressed myelofibrosis in all cases was associated with hepatosplenomegaly. Comparing the morphometric and clinical data, it is established that in the chronic phase of chronic myeloid leukemia in the onset of the disease, the relative area of foci of initial myelofibrosis more than 60 %, the relative area of foci of pronounced myelofibrosis more than 40 %, and the granulocyte-megakaryocytic subtype of bone marrow tumor are associated with the development of relapse or progression of disease after 1st or 2nd line of chemotherapy. In the onset of chronic lymphocytic leukemia, the relative area of foci of initial myelofibrosis more than 20 %, the relative area of foci of pronounced myelofibrosis more than 11 %, and the diffuse type of bone marrow tumor lesion are associated with the development of relapse or progression of disease after 1st or 2nd line of chemotherapy.

chronic myeloid leukemia, chronic lymphocytic leukemia, myelofibrosis, clinical and prognostic value

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