Prospective study of clinical and biological prognostic factors at diagnosis in patients with early stage B-cell chronic lymphocytic leukemia

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BlankProspective study of clinical and biological prognostic factors at

diagnosis in patients with early stage B-cell chronic lymphocytic leukemia.

AC Oliveira, E de la Banda, E Domingo-Domenech, M Encuentra, S Mercadal, A

Domingo, E Alonso, B Espinet, J Grau, AF De Sevilla, and E -Barca

Leuk Lymphoma, March 1, 2011; 52(3): 429-35.

Servei d'Hematologia Cl?nica, Institut Catal? d'Oncologia, Hospital Duran i

Reynals, IDIBELL, Hospitalet, Barcelona, Spain.

Retrospective series have reported many clinical and biological significant

prognostic factors in chronic lymphocytic leukemia (CLL). We describe a

prospective cohort of 135 patients with CLL homogeneously studied at diagnosis

for prognostic factors. Biological variables analyzed were CD38 and ZAP-70

expression, fluorescence in situ hybridization (FISH) for 13q-, +12, 11q-, and

17p-, and conventional cytogenetics. Univariate and multivariate analysis for

progression-free survival (PFS) were performed in patients with early stage (Rai

0-1) CLL. CD38 was positive in 42 (31.6%) patients and ZAP-70 in 47 (35.9%). The

most frequent FISH finding was isolated 13q-?in 50 (38.5%) patients, and

17p-?was found in 11 (8.4%). Among 135 patients, 114 (84.4%) were Rai 0-1 at

diagnosis and 39 (28.9%) presented adenopathies. With a median follow-up of 39

months, the presence of lymphadenopathy in patients with Rai 0-1 stage CLL was

the only significant variable for predicting PFS in multivariate analysis (odds

ratio [OR] 7, 95% confidence interval [CI] 2.2-22, p?=?0.001). When only

biological factors were analyzed, CD38 expression (OR 3.2, 95% CI 1.1-9.3,

p?=?0.03) and 17p-?(OR 3.5, 95% CI 0.95-13.1, p?=?0.05) correlated with worse

PFS. A longer follow-up is necessary to analyze the prognostic value of these

variables regarding overall survival.

PMID: 21323523