title: Implications of new prognostic markers in chronic lymphocytic leukemia.
abstract: Several prognostic markers based on genetic, phenotypic, and molecular characteristics of chronic lymphocytic leukemia (CLL) B cells have emerged in the past decade. The clinical utility of these newer prognostic indicators, alone or in combination with each other and other clinical predictive systems, is still being determined. This chapter attempts to define biologic and molecular underpinnings of 3 sets of prognostic indicators in CLL: genetic abnormalities quantified by FISH and/or defined by exploratory sensitive molecular techniques, expression of specific proteins in or on CLL cells (ie, CD38, CD49d, and ZAP-70), and the IGHV mutation status of a CLL clone. Although not demonstrated conclusively, each probably reflects the biologic properties of the leukemic cells of individual CLL patients. This reflection may be direct, indicating a specific property of the CLL cell itself, or indirect, representing how the CLL cell interacts with the host's microenvironment. The new tyrosine kinase inhibitors that are currently in clinical trials support this interpretation. These and other biology-based indicators of patient clinical course and outcome can be used as starting points from which to understand and treat CLL.
authors.affiliation: The Karches Center for Chronic Lymphocytic Leukemia Research, The Feinstein Institute for Medical Research, Manhasset, NY, USA. NChizzi@NSHS.edu
authors.forename: Nicholas
authors.initials: N
authors.lastname: Chiorazzi
mesh_terms: D051997:ADP-ribosyl Cyclase 1 / Q000096:biosynthesis; D002869:Chromosome Aberrations; D015973:Gene Expression Regulation, Leukemic; D016678:Genome; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D039441:Integrin alpha4 / Q000096:biosynthesis; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000097:blood* / Q000175:diagnosis*; D035683:MicroRNAs / Q000378:metabolism*; D008954:Models, Biological; D009154:Mutation; D009369:Neoplasms / Q000378:metabolism; D020641:Polymorphism, Single Nucleotide; D011379:Prognosis; D016896:Treatment Outcome; D051746:ZAP-70 Protein-Tyrosine Kinase / Q000096:biosynthesis
chemical_list: D035683:MicroRNAs; D039441:Integrin alpha4; D051746:ZAP-70 Protein-Tyrosine Kinase; D051997:ADP-ribosyl Cyclase 1