title: A shorter time to the first treatment may be predicted by the absolute number of regulatory T-cells in patients with Rai stage 0 chronic lymphocytic leukemia.
abstract: Regulatory T-cells (Tregs) are increased in chronic lymphocytic leukemia(CLL) and correlates with clinical and biological features of active/progressive disease. However, little is known about their ability to predict the time to first treatment (TFT). We evaluated 75 patients with Rai stage 0 CLL, in whom the absolute number of Tregs was determined at diagnosis, and correlated to main clinical and biological features, as well as to the need of receiving any specific therapy during the course of the disease. After a median follow-up of 30 months, 12 patients(16%) required therapy at some time from the diagnosis. Treated patients showed a significant higher number of peripheral white blood cells and B-lymphocytes, platelet count, cases with unmutated immunoglobulin heavy chain status, and high-risk cytogenetic abnormalities,as well as lower hemoglobin values, than patients who did not need therapy. A greater number of circulating Tregs was detected in treated patients (P < 0.001). Multivariate analysis confirmed that the absolute number of Tregs was an independent predictor of TFT in these patients, the best predictive cut-off being 41/mL. These data show that the absolute Tregs cell number is able to identify Rai stage 0 CLL patients at higher risk of requiring therapy.
authors.affiliation: Department of Onco-Hematology and Stem Cell Transplantation, IRCCS Centro di Riferimento Oncologico della Basilicata, Rionero in Vulture, Italy. giovannidarena@libero.it
authors.forename: Giovanni
authors.initials: G
authors.lastname: D'Arena
authors.forename: Fiorella
authors.initials: F
authors.lastname: D'Auria
authors.forename: Vittorio
authors.initials: V
authors.lastname: Simeon
authors.forename: Luca
authors.initials: L
authors.lastname: Laurenti
authors.forename: Silvia
authors.initials: S
authors.lastname: Deaglio
authors.forename: Giovanna
authors.initials: G
authors.lastname: Mansueto
authors.forename: Maria Ilaria
authors.initials: MI
authors.lastname: Del Principe
authors.forename: Teodora
authors.initials: T
authors.lastname: Statuto
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Pietrantuono
authors.forename: Roberto
authors.initials: R
authors.lastname: Guariglia
authors.forename: Idanna
authors.initials: I
authors.lastname: Innocenti
authors.forename: Maria Carmen
authors.initials: MC
authors.lastname: Martorelli
authors.forename: Oreste
authors.initials: O
authors.lastname: Villani
authors.forename: Vincenzo
authors.initials: V
authors.lastname: De Feo
authors.forename: Giovanni
authors.initials: G
authors.lastname: Del Poeta
authors.forename: Pellegrino
authors.initials: P
authors.lastname: Musto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D018450:Disease Progression; D005260:Female; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000188:drug therapy / Q000473:pathology*; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors; D050378:T-Lymphocytes, Regulatory / Q000473:pathology*; D013997:Time Factors; D057832:Watchful Waiting