Prognostic markers in chronic lymphocytic leukaemia.
Rai and Binet staging of chronic lymphocytic leukaemia (CLL) is being superseded by new prognostic markers.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.
Hamblin
Terry J
TJ
University of Southampton, c/o Department of Haematology, Royal Bournemouth Hospital, Castle Lane East, Bournemouth BH7 7DW, UK. terjoha@aol.com
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
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