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Clinical utility of molecular and flow cytometric markers in chronic lymphocytic leukaemia.
MedLine Citation:
PMID:  20561095     Owner:  NLM     Status:  In-Data-Review    
Background: Chronic lymphocytic leukaemia (CLL) is a clinically heterogeneous disease. While immunoglobulin variable region heavy chain (IgVH) mutational status remains the 'gold standard' in molecular prognostication, a range of additional markers is increasingly being used in clinical trials. As awareness of trial data increases, requests to determine these prognostic markers for new CLL patients are becoming more prevalent in Australia. Aim: To explore the clinical utility of currently available prognostic markers for CLL in an Australian cohort. Methods: IgVH mutational status and gene usage was determined and compared with other reported immunophenotypic markers, cytogenetics and clinical outcome as defined by treatment-free survival (TFS), lymphocyte doubling time and clinical stage in a cohort of 65 CLL patients. Results: An unmutated IgVH gene, high expression of CD38, ZAP-70, CD25, CD49d, CD54 or low expression of CD49c was associated with shorter TFS indicating an adverse clinical prognosis in our cohort. High expression of each of CD38, ZAP-70, CD49d and CD54 was significantly associated with an unmutated IgVH gene; however, associations were not absolute. IgVH and CD25 expression retained their significance in multivariate analysis. Concordant CD25(high) /IgVH unmutated CLL patients had the shortest median TFS interval (40 months) in our cohort. Conclusions: Molecular and immunophenotypic markers remain useful as adjuncts to clinical prognostication; however, as single parameters they are unable to dictate the timing of therapeutic intervention. The combined use of CD25 and IgVH mutational status may be clinically relevant to CLL prognostication while also providing insight into the biological pathways involved in disease progression.
M L Sulda; B J Kuss; R K Hall; S Bailey; P J Macardle
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Publication Detail:
Type:  Journal Article     Date:  2010-06-16
Journal Detail:
Title:  Internal medicine journal     Volume:  42     ISSN:  1445-5994     ISO Abbreviation:  Intern Med J     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-02-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101092952     Medline TA:  Intern Med J     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  137-46     Citation Subset:  IM    
Copyright Information:
© 2010 The Authors. Internal Medicine Journal © 2010 Royal Australasian College of Physicians.
Departments of Haematology and Genetic Pathology Immunology, Allergy and Arthritis, Flinders Medical Centre School of Biological Sciences, Flinders University, Adelaide, South Australia, Australia.
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