Cardiff University | Prifysgol Caerdydd ORCA
Online Research @ Cardiff 
WelshClear Cookie - decide language by browser settings

Defining the prognosis of early stage chronic lymphocytic leukaemia patients

Pepper, Christopher John, Majid, Aneela, Lin, Thet Thet, Hewamana, Saman, Pratt, Guy, Walewska, Renata, Gesk, Stefan, Siebert, Reiner, Wagner, Simon, Kennedy, Ben, Miall, Fiona, Davis, Zadie A., Tracy, Ian, Gardiner, Anne C., Brennan, Paul, Hills, Robert Kerrin, Dyer, Martin J. S., Oscier, David and Fegan, Christopher Daniel 2012. Defining the prognosis of early stage chronic lymphocytic leukaemia patients. British Journal of Haematology 156 (4) , pp. 499-507. 10.1111/j.1365-2141.2011.08974.x

Full text not available from this repository.

Abstract

Approximately 70% of chronic lymphocytic leukaemia (CLL) patients present with early stage disease, therefore defining which patients will progress and require treatment is a major clinical challenge. Here, we present the largest study of prognostic markers ever carried out in Binet stage A patients (n = 1154) with a median follow-up of 8 years. We assessed the prognostic impact of lymphocyte doubling time (LDT), immunoglobulin gene (IGHV) mutation status, CD38 expression, ZAP-70 expression and fluorescence in situ hybridization (FISH) cytogenetics with regards to time to first treatment (TTFT) and overall survival (OS). Univariate analysis revealed LDT as the most prognostic parameter for TTFT, with IGHV mutation status most prognostic for OS. CD38 expression, ZAP-70 expression and FISH were also prognostic variables; combinations of these markers increased prognostic power in concordant cases. Multivariate analysis revealed that only LDT, IGHV mutation status, CD38 and age at diagnosis were independent prognostic variables for TTFT and OS. Therefore, IGHV mutation status and CD38 expression have independent prognostic value in early stage CLL and should be performed as part of the routine diagnostic workup. ZAP-70 expression and FISH were not independent prognostic markers in early stage disease and can be omitted at diagnosis but FISH analysis should be undertaken at disease progression to direct treatment strategy.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Subjects: R Medicine > R Medicine (General)
R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
Uncontrolled Keywords: chronic lymphocytic leukaemia, prognosis, stage A disease, immunoglobulin gene, CD38
Publisher: Wiley-Blackwell
ISSN: 0007-1048
Last Modified: 08 Jan 2018 21:37
URI: http://orca-mwe.cf.ac.uk/id/eprint/26236

Citation Data

Cited 47 times in Google Scholar. View in Google Scholar

Cited 34 times in Scopus. View in Scopus. Powered By Scopus® Data

Actions (repository staff only)

Edit Item Edit Item