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aDefined by FISH, some cases may have more than one abnormality.

aDefined by FISH, some cases may have more than one abnormality.

Immunophenotype: The immunophenotype of SLL is identical to CLL and the cells express CD5, CD19, CD20, CD23, and restricted surface immunoglobulin.

Molecular genetics: SLL has monoclonally rearranged immunoglobulin heavy (IGH) chain genes, which can be detected by PCR or Southern blot methods. Much has been learned regarding the cytogenetic abnormalities that have prognostic significance.2 Table 52.1 shows the most common abnormalities and their frequency. Cases with del 13q and trisomy 12 have relatively good prognosis compared to those cases with del 11q or del 17p.2 IGH mutational status has also been shown to be an important predictor of outcome. Cases of CLL with unmutated IGH have a relatively poor prognosis compared to those with mutated IGH (>2% deviation from germline sequences).34 Recent expression arrays studies have shown excellent (but not 100%) correlation between ZAP-70 expression (present in unmutated SLL/CLL) and IGH mutational status.

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