Clinical heterogeneity of de novo 11q deletion chronic lymphocytic leukaemia: prognostic relevance of extent of 11q deleted nuclei inside leukemic clone. Issue 2 (2nd October 2012)

• Record Type: Journal Article
• Authors: Marasca, Roberto; Maffei, Rossana; Martinelli, Silvia; Fiorcari, Stefania; Bulgarelli, Jenny; Debbia, Giulia; Rossi, Davide; Rossi, Francesca Maria; Rigolin, Gian Matteo; Martinelli, Sara; Gattei, Valter; Del Poeta, Giovanni; Laurenti, Luca; Forconi, Francesco; Montillo, Marco; Gaidano, Gianluca; Luppi, Mario
• Is Part Of: Hematological oncology. Volume 31:Issue 2(2013:Jun.)
• Page Start: 348
• Page End: 355
• Publication Date: 2012-10-02
• Subjects: Hematological oncology -- Periodicals; Hematology; Medical Oncology; 616.99418005
• DOI: 10.1002/hon.2028
• Languages: English
• ISSNs: 0278-0232

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <p>Deletion on the long arm of chromosome 11 occurs in 5–20% of chronic lymphocytic leukaemia (CLL) patients. We analysed clinical–biological characteristics of 131 CLL patients carrying 11q deletion documented before therapy (<italic>de novo</italic> 11q deleted CLL). <italic>De novo</italic> 11q deleted CLL were characterized by high frequencies of unmutated immunoglobulin variable heavy genes, multiple fluorescence <italic>in situ</italic> hybridization aberrations and lymph node involvement. Factors significantly associated with shorter time to first treatment (TTFT) were advanced Binet stages, high white blood cell count, increased β<sub>2</sub>‐microglobulin levels, 17p in addition, splenomegaly and more extensive lymphadenopathy. We found that patients with <25% 11q deleted nuclei (<italic>n</italic> = 22) experienced longer TTFT compared with patients with ≥25% 11q deleted nuclei (<italic>n</italic> = 87; median TTFT, 40 vs. 14 months, <italic>p</italic> = 0.011) and also showed better response to treatments (complete response, 50% vs. 21%, <italic>p</italic> = 0.016). The variables identified by multivariate analysis as independently associated with reduced TTFT were advanced Binet stages [hazard ratio (HR) 4.69; <italic>p</italic> < 0.001] and ≥25% 11q deleted nuclei (HR 4.73; <italic>p</italic> = 0.004). <italic>De novo</italic> 11q deleted CLLs exhibit variable clinical outcome. The percentage of deleted nuclei inside leukemic clone should be included in the prognostic definition of therapy‐naïve 11q deleted CLL patients.</p> <p>Copyright © 2012 John Wiley & Sons, Ltd.</p> </abstract>