[Basic fibroblast growth factor (bFGF) and vascular endothelial growth factor (VEGF) are elevated in peripheral blood plasma of patients with chronic lymphocytic leukemia and decrease after intensive fludarabine-based treatment]

February 26, 2008

[basic fibroblast growth factor (bFGF) and vascular endothelial growth factor

(VEGF) are elevated in peripheral blood plasma of patients with chronic

lymphocytic leukemia and decrease after intensive fludarabine-based treatment]

L Smolej, C Andrys, J Krejsek, DZ Belada, P Zak, O Siroky, and J Maly

Vnitr Lek, November 1, 2007; 53(11): 1171-6.

Oddelení klinické hematologie II. interní kliniky Lékarské fakulty UK a FN

Hradec Královd. smolej@...

Chronic lymphocytic leukemia (CLL) is characterized by extraordinary

heterogeneity in terms of clinical course with overall survival ranging from

several months to dozens of years. It is currently not possible to accurately

predict the future clinical course in an individual patient. Angiogenesis has

been recently reported as a potential prognostic factor in various hematological

malignancies including CLL. The objective of the present study was to quantify

plasma levels of key angiogenic activators vascular endothelial growth factor

(VEGF) and basic fibroblast growth factor (bFGF) in patients with CLL and

determine their potential change after intensive fludarabine-based treatment.

Peripheral blood EDTA plasma concentrations of bFGF and VEGF were measured using

comercially available enzyme-linked immunosorbent assay in 73 patients with

untreated CLL (43 males, 30 females, median age, 65 years, range 31-88) and 80

healthy donors serving as control group. We found statistically significant

increase in concentrations in patients with chronic lymphocytic leukemia

compared to the control group (p < 0.0001 for both cytokines). No differences in

angiogenic factors were noted between subgroups with low vs. intermediate vs.

high-risk stage according to modified Rai staging or males vs. females. In

twelve patients who achieved at least partial response after intensive

fludarabine-based treatment, levels of bFGF as well as VEGF decreased

significantly (bFGF, p = 0.0005; VEGF, p = 0.0068); in addition, they were no

more significantly different from controls (bFGF, p = 0.524; VEGF, p = 0.728).

Our data showed that key angiogenic activators bFGF and VEGF were elevated in

plasma of CLL patients. Furthemore, treatment with intensive

fludarabine-containing regimens resulted in significant decrease of both

cytokines. These data suggest that angiogenic cytokines may indeed play a

significant role in CLL biology and that treatment with combination of

fludarabine, cyclophosphamide +/- rituximab may exhibit antiangiogenic

properties. Further studies with longer follow-up are necessary for evaluation

of a possible association between angiogenic markers and progression-free

survival or overall survival.

PMID: 18277626

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