Premium
Clinical and molecular predictors of disease severity and survival in chronic lymphocytic leukemia
Author(s) -
Weinberg J. Brice,
Volkheimer Alicia D.,
Chen Youwei,
Beasley Bethany E.,
Jiang Ning,
Lanasa Mark C.,
Friedman Daphne,
Vaccaro Gina,
Rehder Catherine W.,
DeCastro Carlos M.,
Rizzieri David A.,
Diehl Louis F.,
Gockerman Jon P.,
Moore Joseph O.,
Goodman Barbara K.,
Levesque Marc C.
Publication year - 2007
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.20987
Subject(s) - cd38 , chronic lymphocytic leukemia , medicine , gastroenterology , univariate analysis , stage (stratigraphy) , antibody , leukemia , immunology , oncology , biology , multivariate analysis , genetics , cd34 , paleontology , stem cell
Several parameters may predict disease severity and overall survival in chronic lymphocytic leukemia (CLL). The purpose of our study of 190 CLL patients was to compare immunoglobulin heavy chain variable region (IgV H ) mutation status, cytogenetic abnormalities, and leukemia cell CD38 and Zap‐70 to older, traditional parameters. We also wanted to construct a simple, inexpensive prognosis score that would significantly predict TTT and survival in patients at the time of diagnosis and help practicing clinicians. In univariate analyses, patients with higher clinical stage, higher leukocyte count at diagnosis, shorter leukocyte doubling time, elevated serum lactate dehydrogenase (LDH), unmutated immunoglobulin heavy chain variable region (IgV H ) genes, and higher CD38 had a shorter overall survival and time‐to‐treatment (TTT). CLL cell Zap‐70 expression was higher in patients with unmutated IgV H , and those with higher Zap‐70 tended to have shorter survival. IgV H 4‐34 or IgV H 1‐69 was the most common IgV H genes used (16 and 12%, respectively). Of those with IgV H 1‐69, 86% had unmutated IgV H and had a significantly shorter TTT. A cytogenetic abnormality was noted in 71% of the patients tested. Patients with 11q22 del and 17p13 del or complex abnormalities were significantly more likely to have unmutated IgV H . We found that a prognostic score constructed using modified Rai stage, cellular CD38, and serum LDH (parameters easily obtained clinically) significantly predicted TTT and survival in patients at the time of diagnosis and performed as well or better than models using the newer markers. Am. J. Hematol., 2007. © 2007 Wiley‐Liss, Inc.