A 70-year-old man presents with fatigue, recurrent infections, and lymphocytosis of 80 × 10⁹/L. Peripheral blood shows small, mature-appearing lymphocytes with frequent smudge (basket) cells. Flow cytometry shows CD5+, CD19+, CD20(dim)+, CD23+. The cytogenetic finding that confers the BEST prognosis in this disease is:
- A Deletion 17p (TP53)
- B Deletion 13q14 (miR-15a/16) ✓
- C Deletion 11q (ATM)
- D Trisomy 12
Correct answer: B. Deletion 13q14 (miR-15a/16)
Explanation
This is chronic lymphocytic leukemia (CLL), characterized by the CD5+/CD19+/CD23+ phenotype and smudge cells on peripheral smear. The Dohner hierarchical model ranks del(13q14) as the best-prognosis cytogenetic finding in CLL (median survival >10 years), because it only inactivates tumor suppressor miRNAs (miR-15a, miR-16-1). Deletion 17p (TP53) carries the worst prognosis and predicts resistance to chemoimmunotherapy; del(11q) and trisomy 12 are intermediate.
Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.