Autoimmune conditions and chronic infections in chronic lymphocytic leukemia patients at diagnosis are associated with unmutated IgVH genes.
Few data are available concerning the prevalence of autoimmune disease or chronic infections in chronic lymphocytic leukemia patients at diagnosis as well as their clinical outcome. We studied the frequency of such chronic conditions in relation to prognostic markers. A history of autoimmune disease or chronic infection was found in 21% of 186 chronic lymphocytic leukemia patients (12% in autoimmune diseases, 9% in chronic infections). Patients with a history of chronic stimulation were more likely to have unmutated IgV(H) genes (p<0.002), unfavorable or intermediate risk cytogenetics (11q, 17p deletions, trisomy 12) (p<0.001), and higher CD38 expression (p=0.004). Autoimmune conditions (n=22) were characterized by female predominance (55.0%) with a high frequency of unmutated IgV(H) (53,8%). Median time to first treatment was 83 months for the chronic stimulation group compared to 128 months for the non-chronic stimulation group (n.s.). Patients suffering from chronic conditions at chronic lymphocytic leukemia diagnosis are likely to have poor prognostic markers, particularly unmutated IgV(H) genes.
Division of Haematology & Haemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria. katrina.vanura@meduniwien.ac.at
Katrina
K
Vanura
Trang
T
Le
Harald
H
Esterbauer
Florentin
F
Späth
Edit
E
Porpaczy
Medhat
M
Shehata
Karin
K
Eigenberger
Alexander
A
Hauswirth
Cathrin
C
Skrabs
Elisabeth
E
Krömer
Ilse
I
Schwarzinger
Berthold
B
Streubel
Christoph
C
Steininger
Christa
C
Fonatsch
Stephan
S
Stilgenbauer
Oswald
O
Wagner
Alexander
A
Gaiger
Ulrich
U
Jäger
D015551:Autoimmunity; D002908:Chronic Disease; D005803:Genes, Immunoglobulin; D006801:Humans; D007143:Immunoglobulin Heavy Chains / Q000235:genetics; D007135:Immunoglobulin Variable Region / Q000235:genetics; D007239:Infections / Q000209:etiology / Q000276:immunology*; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000150:complications / Q000276:immunology*; D012189:Retrospective Studies
D007143:Immunoglobulin Heavy Chains; D007135:Immunoglobulin Variable Region