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Clinical and molecular predictors of disease severity and survival in chronic lymphocytic leukemia.

Publication ,  Journal Article
Weinberg, JB; Volkheimer, AD; Chen, Y; Beasley, BE; Jiang, N; Lanasa, MC; Friedman, D; Vaccaro, G; Rehder, CW; Decastro, CM; Rizzieri, DA ...
Published in: Am J Hematol
December 2007

Several parameters may predict disease severity and overall survival in chronic lymphocytic leukemia (CLL). The purpose of our study of 190 CLL patients was to compare immunoglobulin heavy chain variable region (IgV(H)) mutation status, cytogenetic abnormalities, and leukemia cell CD38 and Zap-70 to older, traditional parameters. We also wanted to construct a simple, inexpensive prognosis score that would significantly predict TTT and survival in patients at the time of diagnosis and help practicing clinicians. In univariate analyses, patients with higher clinical stage, higher leukocyte count at diagnosis, shorter leukocyte doubling time, elevated serum lactate dehydrogenase (LDH), unmutated immunoglobulin heavy chain variable region (IgV(H)) genes, and higher CD38 had a shorter overall survival and time-to-treatment (TTT). CLL cell Zap-70 expression was higher in patients with unmutated IgV(H), and those with higher Zap-70 tended to have shorter survival. IgV(H)4-34 or IgV(H)1-69 was the most common IgV(H) genes used (16 and 12%, respectively). Of those with IgV(H)1-69, 86% had unmutated IgV(H) and had a significantly shorter TTT. A cytogenetic abnormality was noted in 71% of the patients tested. Patients with 11q22 del and 17p13 del or complex abnormalities were significantly more likely to have unmutated IgV(H). We found that a prognostic score constructed using modified Rai stage, cellular CD38, and serum LDH (parameters easily obtained clinically) significantly predicted TTT and survival in patients at the time of diagnosis and performed as well or better than models using the newer markers.

Duke Scholars

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Published In

Am J Hematol

DOI

ISSN

0361-8609

Publication Date

December 2007

Volume

82

Issue

12

Start / End Page

1063 / 1070

Location

United States

Related Subject Headings

  • ZAP-70 Protein-Tyrosine Kinase
  • Virginia
  • Time Factors
  • Survival Analysis
  • Severity of Illness Index
  • Neoplasm Staging
  • Middle Aged
  • Male
  • Leukemia, Lymphocytic, Chronic, B-Cell
  • Immunology
 

Citation

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Weinberg, J. B., Volkheimer, A. D., Chen, Y., Beasley, B. E., Jiang, N., Lanasa, M. C., … Levesque, M. C. (2007). Clinical and molecular predictors of disease severity and survival in chronic lymphocytic leukemia. Am J Hematol, 82(12), 1063–1070. https://doi.org/10.1002/ajh.20987
Weinberg, J Brice, Alicia D. Volkheimer, Youwei Chen, Bethany E. Beasley, Ning Jiang, Mark C. Lanasa, Daphne Friedman, et al. “Clinical and molecular predictors of disease severity and survival in chronic lymphocytic leukemia.Am J Hematol 82, no. 12 (December 2007): 1063–70. https://doi.org/10.1002/ajh.20987.
Weinberg JB, Volkheimer AD, Chen Y, Beasley BE, Jiang N, Lanasa MC, et al. Clinical and molecular predictors of disease severity and survival in chronic lymphocytic leukemia. Am J Hematol. 2007 Dec;82(12):1063–70.
Weinberg, J. Brice, et al. “Clinical and molecular predictors of disease severity and survival in chronic lymphocytic leukemia.Am J Hematol, vol. 82, no. 12, Dec. 2007, pp. 1063–70. Pubmed, doi:10.1002/ajh.20987.
Weinberg JB, Volkheimer AD, Chen Y, Beasley BE, Jiang N, Lanasa MC, Friedman D, Vaccaro G, Rehder CW, Decastro CM, Rizzieri DA, Diehl LF, Gockerman JP, Moore JO, Goodman BK, Levesque MC. Clinical and molecular predictors of disease severity and survival in chronic lymphocytic leukemia. Am J Hematol. 2007 Dec;82(12):1063–1070.
Journal cover image

Published In

Am J Hematol

DOI

ISSN

0361-8609

Publication Date

December 2007

Volume

82

Issue

12

Start / End Page

1063 / 1070

Location

United States

Related Subject Headings

  • ZAP-70 Protein-Tyrosine Kinase
  • Virginia
  • Time Factors
  • Survival Analysis
  • Severity of Illness Index
  • Neoplasm Staging
  • Middle Aged
  • Male
  • Leukemia, Lymphocytic, Chronic, B-Cell
  • Immunology