title: Should a positive direct antiglobulin test be considered a prognostic predictor in chronic lymphocytic leukemia?
abstract: BACKGROUND
  The clinical course of patients with B-cell CLL is often complicated by autoimmune phenomena. The DAT might be positive at some time during the course of the disease in up to 35% of cases. The aim of this retrospective study was to investigate the relationship between the occurrence of a positive DAT and biological features of CLL patients.
  
  
  METHODS
  In our institution, 146 untreated patients with CLL were studied using the DAT.
  
  
  RESULTS
  According to the statistical analysis, a high level of β2-microglobulin and unmutated IgHV emerged as factors significantly related to the presence of DAT positivity. Time to first TFS was significantly shorter in DAT-positive patients. The adverse effect of a DAT positive result was maintained in terms of TFS when patients with mutated IgHV status were excluded from statistical analysis.
  
  
  CONCLUSIONS
  These results suggest that the DAT might provide additional prognostic information regarding patients with IgHV unmutated status.
authors.affiliation: Department of Oncology/Hematology, Niguarda Ca' Granda Hospital, Milan, Italy. francesca.ricci@ospedaleniguarda.it
authors.forename: Francesca
authors.initials: F
authors.lastname: Ricci
authors.forename: Alessandra
authors.initials: A
authors.lastname: Tedeschi
authors.forename: Eleonora
authors.initials: E
authors.lastname: Vismara
authors.forename: Chiara
authors.initials: C
authors.lastname: Colombo
authors.forename: Silvio
authors.initials: S
authors.lastname: Veronese
authors.forename: Michele
authors.initials: M
authors.lastname: Nichelatti
authors.forename: Roberto
authors.initials: R
authors.lastname: Cairoli
authors.forename: Enrica
authors.initials: E
authors.lastname: Morra
authors.forename: Marco
authors.initials: M
authors.lastname: Montillo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003298:Coombs Test / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000175:diagnosis* / Q000235:genetics / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies
keywords: Autoimmune phenomena; Hemolytic anemia; IgHV unmutated status; Lymphoproliferative diseases; Prognosis