Chronic lymphocytic leukaemia with 17p deletion: a retrospective analysis of prognostic factors and therapy results.
Patients with chronic lymphocytic leukaemia (CLL) whose tumour cells harbour a 17p deletion (17p-) are universally considered to have a poor prognosis. The deletion can be detected at diagnosis or during the evolution of the disease, particularly in patients who have received chemotherapy. We sought to evaluate the natural history of patients with 17p- CLL, identify predictive factors within this prognostic subgroup, and evaluate the results of different therapeutic approaches. Data from 294 patients with 17p- CLL followed up at 20 different institutions was retrospectively collected and analysed. Median age was 68 (range 27-98) years at the time of fluorescence in situ hybridization analysis. After 17p- documentation, 52% received treatment, achieving an overall response rate of 50%. Median overall survival was 41 months, and was significantly shorter in patients with elevated beta(2)-microglobulin concentration (P < 0·001), B symptoms (P = 0·016), higher percentage of cells with deletion (P < 0·001), and acquired deletions (P = 0·012). These findings suggest that patients with 17p- CLL have a variable prognosis that can be refined using simple clinical and laboratory features, including 17p- clone size, beta2-microglobulin concentration, presence of B symptoms and type of deletion (de novo versus acquired).
Department of Haematology, Institute of Haematology and Oncology, Hospital Clinic, IDIBAPS, University of Barcelona, C/Villaroel 170, Barcelona, Spain. jdelgado@clinic.ub.es
Julio
J
Delgado
Blanca
B
Espinet
Ana C
AC
Oliveira
Pau
P
Abrisqueta
Javier
J
de la Serna
Rosa
R
Collado
Javier
J
Loscertales
Montserrat
M
Lopez
Jose A
JA
Hernandez-Rivas
Christelle
C
Ferra
Angel
A
Ramirez
Josep M
JM
Roncero
Cristina
C
Lopez
Anna
A
Aventin
Anna
A
Puiggros
Eugenia
E
Abella
Felix
F
Carbonell
Dolors
D
Costa
Anna
A
Carrio
Marcos
M
Gonzalez
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002872:Chromosome Deletion; D002886:Chromosomes, Human, Pair 17; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000097:blood / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D058496:Smith-Magenis Syndrome; D015996:Survival Rate; D001613:beta 2-Microglobulin / Q000097:blood
D001613:beta 2-Microglobulin