Do Biologic Parameters Affect the Time to First Treatment of Clinical Monoclonal B-Cell Lymphocytosis and Chronic Lymphocytic Leukemia Rai Stage 0? Results of a Prospective Analysis

被引:3
作者
Molica, Stefano [1 ]
Giannarelli, Diana [2 ]
Levato, Luciano [1 ]
Gentile, Massimo [3 ]
Mirabelli, Rosanna [1 ]
Morabito, Fortunato [3 ]
机构
[1] Pugliese Ciaccio Hosp Ctr, Dept Hematol Oncol, Catanzaro, Italy
[2] Regina Elena Inst Canc Res & Treatment, Biostat Unit, Rome, Italy
[3] Cosenza Hosp Ctr, Complex Operat Hematol Unit, Cosenza, Italy
关键词
CLL; cMBL; IGHV; Prognosis; TTFT; GUIDELINES; INDIVIDUALS; DIAGNOSIS; COUNT; MBL;
D O I
10.1016/j.clml.2014.09.003
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
We investigated the clinical relevance of classic and new prognostic markers, immunoglobulin heavy-chain variable (IGHV) gene mutational status, and chromosomal abnormalities in clinical monoclonal B lymphocytosis (cMBL) compared with chronic lymphocytic leukemia (CLL), Rai stage 0. In our prospective patient cohort, we have confirmed that IGHV mutation status appeared to be the best predictor of the time to first treatment in patients with cMBL/CLL Rai stage 0. In addition, when associated with the B-cell count, IGHV mutational status might help to better stratify patients into more precise subgroups. Background: We investigated the clinical relevance of classic and new prognostic markers, immunoglobulin heavy-chain variable (IGHV) gene mutational status, and chromosomal abnormalities in clinical monoclonal B lymphocytosis (cMBL) compared with chronic lymphocytic leukemia (CLL) Rai stage 0. Patients and Methods: We analyzed the clinical outcomes in terms of the time to the first treatment (TTFT) of a prospective cohort, including 125 patients with cMBL and 197 patients with CLL Rai stage 0. Results: In the overall patient population, prognostic parameters such as IGHV gene mutational status (P < .0001), CD38 expression (P < .0001), 70-kDa zeta-associated protein (ZAP-70) expression (P < .0001), and cytogenetic abnormalities (P = .01) predicted for TTFT on univariate analysis. IGHV gene identity was significant on multivariate analysis (P < .0001), regardless of the B-cell cutoff (5.0 or 10 x 10(9) B cells/L). A prognostic stratification using the combination of IGHV mutational status and absolute B-cell lymphocytosis identified 3 different groups that were significantly different with respect to the TTFT (P < .0001). Conclusion: In the present series of patients with cMBL and CLL Rai stage 0, we have confirmed that IGHV mutation status appeared to be the best predictor of TTFT. In addition, when associated with the B-cell count, IGHV mutational status might help to better stratify patients into more precise subgroups. (C) 2015 Elsevier Inc. All rights reserved.
引用
收藏
页码:e55 / e60
页数:6
相关论文
共 26 条
  • [11] Chronic lymphocytic leukemia patients with highly stable and indolent disease show distinctive phenotypic and genotypic features
    Guarini, A
    Gaidano, G
    Mauro, FR
    Capello, D
    Mancini, F
    De Propris, MS
    Mancini, M
    Orsini, E
    Gentile, M
    Breccia, M
    Cuneo, A
    Castoldi, G
    Foa, R
    [J]. BLOOD, 2003, 102 (03) : 1035 - 1041
  • [12] Guidelines for the diagnosis and treatment of chronic lymphocytic leukemia:: a report from the International Workshop on Chronic Lymphocytic Leukemia updating the National Cancer Institute-Working Group 1996 guidelines
    Hallek, Michael
    Cheson, Bruce D.
    Catovsky, Daniel
    Caligaris-Cappio, Federico
    Dighiero, Guillaume
    Doehner, Hartmut
    Hillmen, Peter
    Keating, Michael J.
    Montserrat, Emili
    Rai, Kanti R.
    Kipps, Thomas J.
    [J]. BLOOD, 2008, 111 (12) : 5446 - 5456
  • [13] Is "leukemia" an appropriate label for all patients who meet the diagnostic criteria of chronic lymphocytic leukemia?
    Hoffbrand, A. Victor
    Hamblin, Terry J.
    [J]. LEUKEMIA RESEARCH, 2007, 31 (03) : 273 - 275
  • [14] Monoclonal B cell lymphocytosis and "in situ" lymphoma
    Karube, Kennosuke
    Scarfo, Lydia
    Campo, Elias
    Ghia, Paolo
    [J]. SEMINARS IN CANCER BIOLOGY, 2014, 24 : 3 - 14
  • [15] Monoclonal B-cell lymphocytosis is closely related to chronic lymphocytic leukaemia and may be better classified as early-stage CLL
    Kern, Wolfgang
    Bacher, Ulrike
    Haferlach, Claudia
    Dicker, Frank
    Alpermann, Tamara
    Schnittger, Susanne
    Haferlach, Torsten
    [J]. BRITISH JOURNAL OF HAEMATOLOGY, 2012, 157 (01) : 86 - 96
  • [16] Differentiating chronic lymphocytic leukemia from monoclonal B-lymphocytosis according to clinical outcome: on behalf of the GIMEMA chronic lymphoproliferative diseases working group
    Molica, Stefano
    Mauro, Francesca R.
    Giannarelli, Diana
    Lauria, Francesco
    Cortelezzi, Agostino
    Brugiatelli, Maura
    Liso, Vincenzo
    Cuneo, Antonio
    Foa, Robin
    [J]. HAEMATOLOGICA-THE HEMATOLOGY JOURNAL, 2011, 96 (02): : 277 - 283
  • [17] Clinical Monoclonal B Lymphocytosis versus Rai 0 Chronic Lymphocytic Leukemia: A Comparison of Cellular, Cytogenetic, Molecular, and Clinical Features
    Morabito, Fortunato
    Mosca, Laura
    Cutrona, Giovanna
    Agnelli, Luca
    Tuana, Giacomo
    Ferracin, Manuela
    Zagatti, Barbara
    Lionetti, Marta
    Fabris, Sonia
    Maura, Francesco
    Matis, Serena
    Gentile, Massimo
    Vigna, Ernesto
    Colombo, Monica
    Massucco, Carlotta
    Recchia, Anna Grazia
    Bossio, Sabrina
    De Stefano, Laura
    Ilariucci, Fiorella
    Musolino, Caterina
    Molica, Stefano
    Di Raimondo, Francesco
    Cortelezzi, Agostino
    Tassone, Pierfrancesco
    Negrini, Massimo
    Monti, Sara
    Rossi, Davide
    Gaidano, Gianluca
    Ferrarini, Manlio
    Neri, Antonino
    [J]. CLINICAL CANCER RESEARCH, 2013, 19 (21) : 5890 - 5900
  • [18] Analysis of NOTCH1 mutations in monoclonal B-cell lymphocytosis
    Rasi, Silvia
    Monti, Sara
    Spina, Valeria
    Foa, Robin
    Gaidano, Gianluca
    Rossi, Davide
    [J]. HAEMATOLOGICA-THE HEMATOLOGY JOURNAL, 2012, 97 (01): : 153 - 154
  • [19] Monoclonal B-cell lymphocytosis and chronic lymphocytic leukemia
    Rawstron, Andy C.
    Bennett, Fiona L.
    O'Connor, Sheila J. M.
    Kwok, Marwan
    Fenton, James A. L.
    Plummer, Marieth
    de Tute, Ruth
    Owen, Roger G.
    Richards, Stephen J.
    Jack, Andrew S.
    Hillmen, Peter
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 2008, 359 (06) : 575 - 583
  • [20] The prognosis of clinical monoclonal B cell lymphocytosis differs from prognosis of Rai 0 chronic lymphocytic leukaemia and is recapitulated by biological risk factors
    Rossi, Davide
    Sozzi, Elisa
    Puma, Alessia
    De Paoli, Lorenzo
    Rasi, Silvia
    Spina, Valeria
    Gozzetti, Alessandro
    Tassi, Maristella
    Cencini, Emanuele
    Raspadori, Donatella
    Pinto, Valeria
    Bertoni, Francesco
    Gattei, Valter
    Lauria, Francesco
    Gaidano, Gianluca
    Forconi, Francesco
    [J]. BRITISH JOURNAL OF HAEMATOLOGY, 2009, 146 (01) : 64 - 75