Prospective study of clinical and biological prognostic factors at diagnosis in patients with early stage B-cell chronic lymphocytic leukemia

Abstract

Retrospective series have reported many clinical and biological significant prognostic factors in chronic lymphocytic leukemia (CLL). We describe a prospective cohort of 135 patients with CLL homogeneously studied at diagnosis for prognostic factors. Biological variables analyzed were CD38 and ZAP-70 expression, fluorescence in situ hybridization (FISH) for 13q−, +12, 11q−, and 17p−, and conventional cytogenetics. Univariate and multivariate analysis for progression-free survival (PFS) were performed in patients with early stage (Rai 0–1) CLL. CD38 was positive in 42 (31.6%) patients and ZAP-70 in 47 (35.9%). The most frequent FISH finding was isolated 13q− in 50 (38.5%) patients, and 17p− was found in 11 (8.4%). Among 135 patients, 114 (84.4%) were Rai 0–1 at diagnosis and 39 (28.9%) presented adenopathies. With a median follow-up of 39 months, the presence of lymphadenopathy in patients with Rai 0–1 stage CLL was the only significant variable for predicting PFS in multivariate analysis (odds ratio [OR] 7, 95% confidence interval [CI] 2.2–22, p = 0.001). When only biological factors were analyzed, CD38 expression (OR 3.2, 95% CI 1.1–9.3, p = 0.03) and 17p− (OR 3.5, 95% CI 0.95–13.1, p = 0.05) correlated with worse PFS. A longer follow-up is necessary to analyze the prognostic value of these variables regarding overall survival.

Keywords:

• Prospective
• prognostic factors
• early stage
• CLL

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.