A prognostic model for survival in chronic lymphocytic leukaemia based on p53 expression.
As the abnormal expression of p53 protein is prognostically significant in some human cancers, its significance in patients with B-cell chronic lymphocytic leukaemia (CLL) was assessed. Two investigators evaluated the percentage of bone marrow mononuclear cells that stained for p53, using biopsies stained with anti-p53 monoclonal antibody (DO-7), and graded the degree of staining (0, +, ++, +++). Samples from a cohort of 90 patients with CLL were studied (median age 60 years, range 30-89 years; 57 patients were (63%) previously untreated, 22 patients (24%) had received one or two prior regimens, 11 patients had received (12%) three to seven regimens. The overall percentage of cells positive for p53 staining was a median of 43 (range 1-88). No investigator effect was detected either in overall percentage cells rated p53 positive or on the degree of staining (Pearson's correlation coefficient 0.980, P-value < 0.001). A Cox proportional hazards model showed that the percentage of ++ and +++ p53-positive cells correlated with various prognostic factors in CLL (P < 0.0001). A multivariate model incorporating prior therapy, Rai stage, beta2 microglobulin (beta2M) and p53 expression showed that only the percentage of p53-positive cells and beta2M were predictive of survival, and enabled the development of a highly predictive model of survival based on these two parameters.
Giles
Francis J
FJ
Department of Leukaemia, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA.
Bekele
B Nebiyou
BN
O'Brien
Susan
S
Cortes
Jorge E
JE
Verstovsek
Srdan
S
Balerdi
Maria
M
Yared
Marwan
M
Zhou
Xian
X
Kantarjian
Hagop M
HM
Keating
Michael J
MJ
Thall
Peter
P
Albitar
Maher
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D007150:Immunohistochemistry; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000235:genetics / Q000401:mortality*; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D015203:Reproducibility of Results; D016019:Survival Analysis; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism*
D016159:Tumor Suppressor Protein p53