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The risk factors analysis in 248 patients with B-cell chronic lymphocytic leukemia at diagnosis


Authors: E. Cmunt 1;  M. Trněný 1;  J. Karban 1;  J. Šálková 1;  K. Michalová 2;  Z. Zemanová 2;  L. Pavlištová 2;  J. Schwarz 3;  S. Peková 3
Authors‘ workplace: I. interní klinika VFN a 1. LF UK, Praha, 2Centrum nádorové cytogenetiky, Ústav klinické biochemie a laboratorní diagnostiky VFN a 1. LF UK, Praha, 3Ústav hematologie a krevní transfuze, Praha 1
Published in: Transfuze Hematol. dnes,12, 2006, No. 4, p. 232-239.
Category: Comprehensive Reports, Original Papers, Case Reports

Overview

248 patients (139 men and 109 women) with B-cell chronic lymphocytic leukemia were evaluated at diagnosis with respect of clinical stage, CD38 and ZAP-70 expression, cytogenetic changes (by FISH method) and IgVH mutation status and impact of these for overall survival. 203 patients (82,9 %) were in Rai 0 and I clinical stage, 25 patients (10,2 %) were in stage II and 17 patients (7,0 %) were in stage III and IV. CD38 expression was evaluated at 137 patients (55,2 %), positive was at 49 patients (35,8 %), negative was at 88 (64,2 %) patients. ZAP-70 expression was evaluated in 109 patients (44 % from the total number), positive was in 44 patients (40,4 %), negative in 65 (59,6 %) patients. From 160 evaluations of IgVH mutation status (64,5 % of the total number of patients) 71 (44,4 %) patients were non-mutated and 89 (55,6 %) cases were mutated. From 192 evaluated patients (77,4 % of the total number of patients) trisomy of 12 chromosome was present in 22 patients (11,5 %), one case was borderline (0,5 %), 13(q14) deletion was present in 107 cases (56,6 %) out of 189 evaluated (76,2 % of the total number of patients), 11(q23) deletion was found in 4 cases (12,9 %) out of 31 evaluated (12,5 % of the total number of patients), 11(q22.3) deletion was present in 13 cases (16,5 %) out of 79 evaluated (31,9 %) and 17(p13) deletion by 22 patients (11,4) out of 193 evaluated (77,8 %). 48 patients died (19,4 %), overall survival in 5 years was 83,5 %, in 10 years 58,2 %. According to our analysis sex (p=0,0002), Rai clinical stage (p=0,0002), IgVH mutation status (p=0,0001), 17(p13) deletion (p=0,09), CD38 (p=0,05) and ZAP-70 expression (p=0,02) revealed to be significant prognostic risk factors.

Key words:
B-cell chronic lymphocytic leukemia, prognosis, imunophenotyping, cytogenetics (FISH), IgVH mutation status


Labels
Haematology Internal medicine Clinical oncology

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