TY - JOUR
T1 - Clinical and molecular predictors of disease severity and survival in chronic lymphocytic leukemia
AU - Weinberg, J. Brice
AU - Volkheimer, Alicia D.
AU - Chen, Youwei
AU - Beasley, Bethany E.
AU - Jiang, Ning
AU - Lanasa, Mark C.
AU - Friedman, Daphne
AU - Vaccaro, Gina
AU - Rehder, Catherine W.
AU - DeCastro, Carlos M.
AU - Rizzieri, David A.
AU - Diehl, Louis F.
AU - Gockerman, Jon P.
AU - Moore, Joseph O.
AU - Goodman, Barbara K.
AU - Levesque, Marc C.
PY - 2007/12
Y1 - 2007/12
N2 - 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 (IgVH) 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 (IgVH) 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. IgVH4-34 or IgVH1-69 was the most common IgVH genes used (16 and 12%, respectively). Of those with IgVH1-69, 86% had unmutated IgVH 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 IgVH. 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.
AB - 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 (IgVH) 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 (IgVH) 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. IgVH4-34 or IgVH1-69 was the most common IgVH genes used (16 and 12%, respectively). Of those with IgVH1-69, 86% had unmutated IgVH 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 IgVH. 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.
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U2 - 10.1002/ajh.20987
DO - 10.1002/ajh.20987
M3 - Article
C2 - 17654680
AN - SCOPUS:36749001049
SN - 0361-8609
VL - 82
SP - 1063
EP - 1070
JO - American Journal of Hematology
JF - American Journal of Hematology
IS - 12
ER -