Clonal chromosomal changes in chronic lymphocytic leukemia.

Cytogenetic analysis was carried out in 28 B-CLL patients (21 males and 7 females, 38-85 years old, with median age 64 years, disease stage O-IV). Peripheral nominator cells (1 x 10(7)) or isolated B-lymphocytes were incubated in vitro for 5-7 days. The cells were stimulated by pokeweed mitogen (PWM), or phorbol myristate-acetate (PMA), with or without 10% conditioned medium (CM) derived from a T cell leukemia line or 10% B-cell growth factor (BCGF). Twenty-two patients (79%) responded to PWM + CM; 5 out of 5 patients responded to PWM + BCGF. The average mitotic index (+/- S.E.M.) for PWM, PMA, PWM + CM, PMA + CM, PWM + BCGF were 0.13 +/- 0.01, 0.24 +/- 0.13, 0.51 +/- 0.11, 0.14 +/- 0.06 and 0.63 +/- 0.15, respectively. Cytogenetic analysis revealed the presence of abnormal karyotypes in 22 patients. Fourteen patients (50%) had clonal chromosome aberrations which included: monosomy 1, 9, 17, 18, 21, and X chromosome, and trisomy of chromosomes 7, 9, 20, 21 and 22. The clonal structural aberrations were i(6q), inv(12) (q15q24), del(5) (p13p15), del(10) (q24). No homogeneously staining regions (HSR) were observed. Four patients with resistance to anti-neoplastic drugs showed the presence of double minute chromosomes (dmin) ranging in frequency from 5 to 50%.