title: Prospective study of clinical and biological prognostic factors at diagnosis in patients with early stage B-cell chronic lymphocytic leukemia.
abstract: Retrospective series have reported many clinical and biological significant prognostic factors in chronic lymphocytic leukemia (CLL). We describe a prospective cohort of 135 patients with CLL homogeneously studied at diagnosis for prognostic factors. Biological variables analyzed were CD38 and ZAP-70 expression, fluorescence in situ hybridization (FISH) for 13q-, +12, 11q-, and 17p-, and conventional cytogenetics. Univariate and multivariate analysis for progression-free survival (PFS) were performed in patients with early stage (Rai 0-1) CLL. CD38 was positive in 42 (31.6%) patients and ZAP-70 in 47 (35.9%). The most frequent FISH finding was isolated 13q- in 50 (38.5%) patients, and 17p- -was found in 11 (8.4%). Among 135 patients, 114 (84.4%) were Rai 0-1 at diagnosis and 39 (28.9%) presented adenopathies. With a median follow-up of 39 months, the presence of lymphadenopathy in patients with Rai 0-1 stage CLL was the only significant variable for predicting PFS in multivariate analysis (odds ratio [OR] 7, 95% confidence interval [CI] 2.2-22, p = 0.001). When only biological factors were analyzed, CD38 expression (OR 3.2, 95% CI 1.1-9.3, p = 0.03) and 17p- (OR 3.5, 95% CI 0.95-13.1, p = 0.05) correlated with worse PFS. A longer follow-up is necessary to analyze the prognostic value of these variables regarding overall survival.
authors.affiliation: Servei d'Hematologia Clínica, Institut Català d'Oncologia, Hospital Duran i Reynals, IDIBELL, Hospitalet, Barcelona, Spain. acoliveira@iconcologia.net
authors.forename: Ana C
authors.initials: AC
authors.lastname: Oliveira
authors.forename: Esmeralda
authors.initials: E
authors.lastname: de la Banda
authors.forename: Eva
authors.initials: E
authors.lastname: Domingo-Domenech
authors.forename: Maite
authors.initials: M
authors.lastname: Encuentra
authors.forename: Santiago
authors.initials: S
authors.lastname: Mercadal
authors.forename: Alicia
authors.initials: A
authors.lastname: Domingo
authors.forename: Esther
authors.initials: E
authors.lastname: Alonso
authors.forename: Blanca
authors.initials: B
authors.lastname: Espinet
authors.forename: Javier
authors.initials: J
authors.lastname: Grau
authors.forename: Alberto Fernandez
authors.initials: AF
authors.lastname: De Sevilla
authors.forename: Eva
authors.initials: E
authors.lastname: Gonzalez-Barca
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis*; D015331:Cohort Studies; D020732:Cytogenetic Analysis; D018572:Disease-Free Survival; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D016130:Immunophenotyping; D007621:Karyotyping; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D016019:Survival Analysis
chemical_list: D014408:Biomarkers, Tumor