The prognosis of clinical monoclonal B cell lymphocytosis differs from prognosis of Rai 0 chronic lymphocytic leukaemia and is recapitulated by biological risk factors

Autor: Donatella Raspadori, Lorenzo De Paoli, Francesco Bertoni, Valeria Spina, Alessandro Gozzetti, Davide Rossi, Maristella Tassi, Gianluca Gaidano, Emanuele Cencini, Valter Gattei, Francesco Lauria, Francesco Forconi, Elisa Sozzi, Valeria Pinto, Silvia Rasi, Alessia Puma
Rok vydání: 2009
Předmět:
Oncology
p53
Male
Aged
B-Lymphocytes
Complementarity Determining Regions
genetics
Disease Progression
Disease-Free Survival
Female
Flow Cytometry
methods
Follow-Up Studies
Gene Deletion
Gene Rearrangement
Genes
p53
Humans
Immunoglobulin Heavy Chains
genetics
Immunoglobulin Variable Region
genetics
In Situ Hybridization
Fluorescence
methods
Leukemia
Lymphocytic
Chronic
B-Cell
genetics/immunology/mortality
Lymphocytosis
genetics/immunology/mortality
Male
Middle Aged
Multigene Family
Mutation
Prognosis
Proportional Hazards Models
Survival Rate
Tumor Markers
Biological
analysis
Lymphocytosis
Chronic lymphocytic leukemia
Immunoglobulin Variable Region
genetics
genetics/immunology/mortality
Tumor Markers
In Situ Hybridization
In Situ Hybridization
Fluorescence
Gene Rearrangement
B-Lymphocytes
Leukemia
Hazard ratio
Hematology
Middle Aged
Flow Cytometry
Prognosis
Survival Rate
Multigene Family
Monoclonal
Disease Progression
Monoclonal B-cell lymphocytosis
Female
medicine.symptom
IGHV@
Immunoglobulin Heavy Chains
medicine.medical_specialty
Biology
Disease-Free Survival
methods
Internal medicine
medicine
Biomarkers
Tumor
Humans
Survival rate
Aged
Proportional Hazards Models
Gene rearrangement
medicine.disease
Genes
p53
Complementarity Determining Regions
Leukemia
Lymphocytic
Chronic
B-Cell
Genes
Immunology
Mutation
Gene Deletion
Follow-Up Studies
Zdroj: British journal of haematology. 146(1)
ISSN: 1365-2141
Popis: Monoclonal B-cell lymphocytosis (MBL) is an asymptomatic monoclonal expansion of5.0 x 10(9)/l circulating CLL-phenotype B-cells. The relationship between MBL and Rai 0 CLL, as well as the impact of biological risk factors on MBL prognosis, are unknown. Out of 460 B-cell expansions with CLL-phenotype, 123 clinical MBL (cMBL) were compared to 154 Rai 0 CLL according to clinical and biological profile and outcome. cMBL had better humoral immune capacity and lower infection risk, lower prevalence of del11q22-q23/del17p13 and TP53 mutations, slower lymphocyte doubling time, and longer treatment-free survival. Also, cMBL diagnosis was a protective factor for treatment risk. Despite these favourable features, all cMBL were projected to progress, and lymphocytes1.2 x 10(9)/l and3.7 x 10(9)/l were the best thresholds predicting the lowest and highest risk of progression to CLL. Although IGHV status, CD38 and CD49d expression, and fluorescence in situ hybridization (FISH) karyotype individually predicted treatment-free survival, multivariate analysis identified the presence of +12 or del17p13 as the sole independent predictor of treatment requirement in cMBL (Hazard ratio: 5.39, 95% confidence interval 1.98-14.44, P = 0.001). Overall, these data showed that cMBL has a more favourable clinical course than Rai 0 CLL. Given that the biological profile can predict treatment requirement, stratification based on biological prognosticators may be helpful for cMBL management.
Databáze: OpenAIRE
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