title: White blood cell count at diagnosis and immunoglobulin variable region gene mutations are independent predictors of treatment-free survival in young patients with stage A chronic lymphocytic leukemia.
abstract: A comprehensive panel of clinical-biological parameters was prospectively evaluated at presentation in 112 patients with chronic lymphocytic leukemia (<65 years), to predict the risk of progression in early stage disease. Eighty-one percent were in Binet stage A, 19% in stages B/C. Treatment-free survival was evaluated as the time from diagnosis to first treatment, death or last follow up. In univariate analysis, advanced stage, hemoglobin, platelets, white blood cell, leukemic lymphocyte count, raised beta 2-microglobulin and LDH, unmutated immunoglobulin variable region genes, CD38, del(17p), del(11q) and +12, were significantly associated with a short treatment-free survival; the T/leukemic lymphocyte ratio was associated with a better outcome. Multivariate analysis of treatment-free survival in stage A patients selected a high white blood cell count and unmutated immunoglobulin variable region genes as unfavorable prognostic factors and a high T/leukemic lymphocyte ratio as a favorable one. At diagnosis, these parameters independently predict the risk of progression in stage A chronic lymphocytic leukemia patients.
authors.affiliation: Division of Hematology, Department of Cellular Biotechnologies and Hematology, Sapienza University, Via Benevento 6, 00161 Rome, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Del Giudice
authors.forename: Francesca Romana
authors.initials: FR
authors.lastname: Mauro
authors.forename: Maria Stefania
authors.initials: MS
authors.lastname: De Propris
authors.forename: Simona
authors.initials: S
authors.lastname: Santangelo
authors.forename: Marilisa
authors.initials: M
authors.lastname: Marinelli
authors.forename: Nadia
authors.initials: N
authors.lastname: Peragine
authors.forename: Valeria
authors.initials: V
authors.lastname: Di Maio
authors.forename: Mauro
authors.initials: M
authors.lastname: Nanni
authors.forename: Rita
authors.initials: R
authors.lastname: Barzotti
authors.forename: Francesca
authors.initials: F
authors.lastname: Mancini
authors.forename: Daniele
authors.initials: D
authors.lastname: Armiento
authors.forename: Francesca
authors.initials: F
authors.lastname: Paoloni
authors.forename: Anna
authors.initials: A
authors.lastname: Guarini
authors.forename: Robin
authors.initials: R
authors.lastname: Foà
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007135:Immunoglobulin Variable Region / Q000235:genetics*; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000097:blood* / Q000188:drug therapy / Q000235:genetics* / Q000401:mortality / Q000473:pathology; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009154:Mutation / Q000235:genetics*; D009367:Neoplasm Staging; D011379:Prognosis; D012307:Risk Factors; D016019:Survival Analysis; D016159:Tumor Suppressor Protein p53 / Q000235:genetics
chemical_list: D007135:Immunoglobulin Variable Region; D016159:Tumor Suppressor Protein p53