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Smudge Cells Point to Survival in Patients with Leukemia

Higher smudge percentage linked to improved survival in chronic lymphocytic leukemia

WEDNESDAY, Mar. 11 (HealthDay News) -- Smudge cells on blood smears from patients with chronic lymphocytic leukemia can predict survival of the disease, according to research published online Mar. 2 in the Journal of Clinical Oncology.

Grzegorz S. Nowakowski, M.D., of the Mayo Clinic in Rochester, Minn., and colleagues analyzed data from 108 patients with chronic lymphocytic leukemia (CLL) from whom blood smears were available. Smudge cells are ruptured CLL B cells that show up on blood smears from nearly all CLL patients and were long thought to be a slide-preparation artifact.

Smudge cell percentage was associated with longer survival, the researchers report. For patients with 30 percent or fewer smudge cells, the 10-year survival rate was 50 percent, compared with 80 percent survival for patients with higher numbers of smudge cells. The percentage of smudge cells was lower in CD38+ patients and Zap70-positive patients, the report indicates.

Previous research has "demonstrated that smudge cell formation is inversely correlated with CLL B cell content of vimentin, a cytoskeletal protein critical for rigidity and integrity of lymphocytes. The physiologic role of vimentin may extend beyond maintaining cell integrity; rearrangement of vimentin fibers was shown to participate in cell activation and signal transduction. High vimentin expression has been shown to be associated with poor prognosis and metastatic potential in breast and colon cancer," the authors write.

A study co-author disclosed financial relationships with Hospira and Bayer.

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