{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T18:30:34Z","timestamp":1773685834554,"version":"3.50.1"},"reference-count":38,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2024,1,22]],"date-time":"2024-01-22T00:00:00Z","timestamp":1705881600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Atypical chronic lymphocytic leukemia (CLL) is still defined according to morphological criteria. However, deviance from the typical surface immunological profile suggests an atypical immunological-based CLL. A large cohort of patients with CLL was retrospectively evaluated aiming at assessing morphological (FAB criteria), immunophenotypical (two or more discordances from the typical profile), and clinical\u2013biological features of atypical CLL. Compared to typical cases, morphologically atypical CLL showed a greater percentage of unmutated IgVH and CD38 positivity, and a higher expression of CD20. Immunophenotypically atypical CLL was characterized by more advanced clinical stages, higher expression of CD20, higher rate of FMC7, CD79b and CD49d positivity, and by an intermediate\u2013high expression of membrane surface immunoglobulin, compared to typical cases. When patients were categorized based on immunophenotypic and morphologic concordance or discordance, no difference emerged. Finally, morphological features better discriminated patients\u2019 prognosis in terms of time-to-first treatment, while concordant atypical cases showed overall a worse prognosis. Discordant cases by immunophenotype and\/or morphology did not identify specific prognostic groups. Whether\u2014in the era of molecular markers used as prognostic indicators\u2014it does make sense to focus on morphology and immunophenotype features in CLL is still matter of debate needing further research.<\/jats:p>","DOI":"10.3390\/cancers16020469","type":"journal-article","created":{"date-parts":[[2024,1,22]],"date-time":"2024-01-22T06:49:31Z","timestamp":1705906171000},"page":"469","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["What Does Atypical Chronic Lymphocytic Leukemia Really Mean? A Retrospective Morphological and Immunophenotypic Study"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3807-7287","authenticated-orcid":false,"given":"Giovanni","family":"D\u2019Arena","sequence":"first","affiliation":[{"name":"Immuno-Hematology and Transfusion Medicine Unit, \u201cSan Luca\u201d Hospital, 84078 Vallo della Lucania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2592-8724","authenticated-orcid":false,"given":"Candida","family":"Vitale","sequence":"additional","affiliation":[{"name":"A.O.U. Citt\u00e0 della Salute e della Scienza di Torino and Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Torino, 10125 Torino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Pietrantuono","sequence":"additional","affiliation":[{"name":"Hematology and Stem Cell Transplantation Unit, Centro di Riferimento Oncologico della Basilicata (IRCCS-CROB), 85028 Rionero in Vulture, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oreste","family":"Villani","sequence":"additional","affiliation":[{"name":"Hematology and Stem Cell Transplantation Unit, Centro di Riferimento Oncologico della Basilicata (IRCCS-CROB), 85028 Rionero in Vulture, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanna","family":"Mansueto","sequence":"additional","affiliation":[{"name":"Hematology and Stem Cell Transplantation Unit, Centro di Riferimento Oncologico della Basilicata (IRCCS-CROB), 85028 Rionero in Vulture, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3030-1651","authenticated-orcid":false,"given":"Fiorella","family":"D\u2019Auria","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Pathology, Centro di Riferimento Oncologico della Basilicata (IRCCS-CROB), 85028 Rionero in Vulture, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2127-2104","authenticated-orcid":false,"given":"Teodora","family":"Statuto","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Research and Advanced Diagnostics, Centro di Riferimento Oncologico della Basilicata (IRCCS-CROB), 85028 Rionero in Vulture, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simona","family":"D\u2019Agostino","sequence":"additional","affiliation":[{"name":"Hematology and Stem Cell Transplantation Unit, Centro di Riferimento Oncologico della Basilicata (IRCCS-CROB), 85028 Rionero in Vulture, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosalaura","family":"Sabetta","sequence":"additional","affiliation":[{"name":"Immuno-Hematology and Transfusion Medicine Unit, \u201cSan Luca\u201d Hospital, 84078 Vallo della Lucania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela","family":"Tarasco","sequence":"additional","affiliation":[{"name":"Immuno-Hematology and Transfusion Medicine Unit, \u201cSan Luca\u201d Hospital, 84078 Vallo della Lucania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Idanna","family":"Innocenti","sequence":"additional","affiliation":[{"name":"Hematology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Autore","sequence":"additional","affiliation":[{"name":"Hematology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8084-9009","authenticated-orcid":false,"given":"Alberto","family":"Fresa","sequence":"additional","affiliation":[{"name":"Hematology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6382-7318","authenticated-orcid":false,"given":"Luciana","family":"Valvano","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Research and Advanced Diagnostics, Centro di Riferimento Oncologico della Basilicata (IRCCS-CROB), 85028 Rionero in Vulture, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annamaria","family":"Tomasso","sequence":"additional","affiliation":[{"name":"Hematology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorenzo","family":"Cafaro","sequence":"additional","affiliation":[{"name":"Immuno-Hematology and Transfusion Medicine Unit, \u201cImmacolata\u201d Hospital, 84073 Sapri, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1114-1963","authenticated-orcid":false,"given":"Daniela","family":"Lamorte","sequence":"additional","affiliation":[{"name":"Laboratory of Preclinical and Translational Research, Centro di Riferimento Oncologico della Basilicata (IRCCS-CROB), 85028 Vulture, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8327-1396","authenticated-orcid":false,"given":"Luca","family":"Laurenti","sequence":"additional","affiliation":[{"name":"Hematology Unit, Fondazione Policlinico Universitario A. 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