Premium
Baff serum level predicts time to first treatment in early chronic lymphocytic leukemia
Author(s) -
Molica Stefano,
Digiesi Giovanna,
Battaglia Caterina,
Cutrona Giovanna,
Antenucci Anna,
Molica Matteo,
Giannarelli Diana,
Sperduti Isabella,
Gentile Massimo,
Morabito Fortunato,
Ferrarini Manlio
Publication year - 2010
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/j.1600-0609.2010.01482.x
Subject(s) - b cell activating factor , chronic lymphocytic leukemia , medicine , gastroenterology , hazard ratio , cd38 , immunology , stage (stratigraphy) , confidence interval , proportional hazards model , leukemia , oncology , antibody , b cell , biology , paleontology , stem cell , cd34 , genetics
We analyzed the correlation between well‐established biological parameters of prognostic relevance in B‐cell chronic lymphocytic leukemia (CLL) [i.e. mutational status of the immunoglobulin heavy chain variable region (IgVH), ZAP‐70 and CD38 expression] and serum levels of B cell–activating factor (BAFF of the TNF family) by evaluating the impact of these variables on the time to first treatment (TFT) in a series of 169 previously untreated CLL patients in Binet stage A. Higher levels of BAFF were more frequently associated with female gender ( P = 0.02), younger age ( P = 0.01), Rai stage 0 ( P = 0.002), higher platelet count ( P = 0.005), mutated IgVH disease ( P = 0.002), higher occurrence of normal cytogenetic profile or presence of 13q deletion ( P = 0.02), low ZAP‐70‐ ( P = 0.003), and CD38‐expression ( P = 0.02). Maximally selected log‐rank statistic plot identified a serum BAFF concentration of 0.313 ng/mL as the best cut‐off ( P < 0.0001). This threshold recognized two subsets of patients with different TFT ( P < 0.0001). Because in multivariate analysis soluble BAFF [Hazard ratio (HR), 8.23; confidence Interval (CI) 95%,3.0–22.6, P < 0.0001] and mutational status of IgVH (HR = 2.60; CI 95% 1.10–6.14, P = 0.03) maintained the discriminating power their combined effect on clinical outcome was assessed. When three groups were considered: (1) low‐risk ( n = 93), patients with concordant IgVH mut and higher soluble BAFF; (2) intermediate‐risk ( n = 50), patients with IgVH mut and low BAFF levels or IgVH unmut and soluble higher BAFF;(3) high‐risk ( n = 26), patients with concordant IgVH unmut and low soluble BAFF, the 2‐yr TFTs were, respectively, 95%, 85%, and 41% ( P < 0.0001). In conclusion, our results indicate that in early B‐cell CLL, the biological profile including among other parameters soluble BAFF may provide a useful insight into the complex interrelationship of prognostic variables.