title: Prognostic markers in chronic lymphocytic leukaemia.
abstract: Rai and Binet staging of chronic lymphocytic leukaemia (CLL) is being superseded by new prognostic markers. The mutational status of the immunoglobulin variable region heavy-chain genes segregates the disease into more benign and more malignant versions, and has been confirmed as an important prognostic marker in prospective clinical trials. A search for surrogate markers for this difficult-to-perform assay has led to flow cytometric assays for CD38 and ZAP-70 expression, although in both cases there are problems with standardization and interpretation of the assays. A separate pathway of research has revealed two chromosomal aberrations--deletions of 11q and 17p--as important prognostic markers. Fluorescent in-situ hybridization has made their detection readily available. These five markers are in different stages of evaluation, but some of them are ready to be used for risk-adapted therapy in clinical trials. Other assays are in earlier stages of assessment.
authors: University of Southampton, c/o Department of Haematology, Royal Bournemouth Hospital, Castle Lane East, Bournemouth BH7 7DW, UK. terjoha@aol.com
authors: Terry J
authors: TJ
authors: Hamblin
mesh_terms: D051997:ADP-ribosyl Cyclase 1 / Q000032:analysis; D014408:Biomarkers, Tumor / Q000032:analysis*; D049109:Cell Proliferation; D002869:Chromosome Aberrations; D006801:Humans; D007143:Immunoglobulin Heavy Chains / Q000235:genetics; D007135:Immunoglobulin Variable Region / Q000235:genetics; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000175:diagnosis* / Q000473:pathology*; D008214:Lymphocytes / Q000166:cytology; D008562:Membrane Glycoproteins / Q000032:analysis; D009367:Neoplasm Staging; D011379:Prognosis; D013937:Thymidine Kinase / Q000097:blood; D051746:ZAP-70 Protein-Tyrosine Kinase / Q000032:analysis
chemical_list: D014408:Biomarkers, Tumor; D007143:Immunoglobulin Heavy Chains; D007135:Immunoglobulin Variable Region; D008562:Membrane Glycoproteins; D013937:Thymidine Kinase; D051746:ZAP-70 Protein-Tyrosine Kinase; C498154:CD38 protein, human; D051997:ADP-ribosyl Cyclase 1