A study of bone marrow neoangiogenesis in chronic lymphocytic leukemia patients.

OBJECTIVE

To use a purely geometric data-unravelling method to identify, without a priori, direct links of neoangiogenesis with known clinicobiologic variables in 23 untreated chronic lymphocytic leukemia (CLL) patients at the time of marrow sampling.

STUDY

DESIGN

We measured neovascular surface density (CD34 endothelial marker) in the 10 most labeled fields (hVA), cellularity (CA) and the percentage of avascular fields (AVF) in bone marrow biopsy specimens from 34 patients with CLL. Vascular endothelial growth factor (VEGF) was assayed in thawed serum samples from 8 of the 23 untreated patients (12 Rai stage 0, 6 Rai stage I-II, 5 Binet stage B-C).

RESULTS

Neoangiogenesis hVA was lower in the 12 stage O patients (p < 0.039) and in the 6 patients with nodular interstitial mixed infiltration (p = 0.058). The link between hVA and serum VEGF (sVEGF) was negative in 8 patients (R = -0.49, -0.70 for a given age). Age was linked to moderate interstitial infiltration (p < 0.02), AVF (R = 0.37) and lower sVEGF levels (R = -0.676). The blood platelet count showed numerous correlations, including links with AVF (R = 0.40), low hVA (R = -0.38), female sex (p = 0.068), absence of splenomegaly (p < 0.001), mixed-type infiltration (p < 0.01) and sVEGF (R = 0.38, 0.61 for a given age).

CONCLUSION

The links revealed by the iconography of correlations were described statistically. Surprisingly, negative links of hVA with the sVEGF level, 2 known prognostic factors, on the one hand, and with the blood platelet count, on the other hand, were found. The direct link between disease progression and the amount of avascular hematopoietic tissue (NS), not previously described, will require further study. Age should be taken into account.