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.
Vanura
Katrina
K
Division of Haematology & Haemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria. katrina.vanura@meduniwien.ac.at
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Trang
T
Esterbauer
Harald
H
Späth
Florentin
F
Porpaczy
Edit
E
Shehata
Medhat
M
Eigenberger
Karin
K
Hauswirth
Alexander
A
Skrabs
Cathrin
C
Krömer
Elisabeth
E
Schwarzinger
Ilse
I
Streubel
Berthold
B
Steininger
Christoph
C
Fonatsch
Christa
C
Stilgenbauer
Stephan
S
Wagner
Oswald
O
Gaiger
Alexander
A
Jäger
Ulrich
U
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