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Published on: July 20, 2016
Prognostic markers in chronic lymphocytic leukaemia
1University of Southampton, c/o Department of Haematology, Royal Bournemouth Hospital, Castle Lane East, Bournemouth BH7 7DW, UK. terjoha@aol.com
Best Practice & Research. Clinical Haematology
|August 21, 2007
Summary
New prognostic markers are replacing traditional staging for chronic lymphocytic leukaemia (CLL). Immunoglobulin gene mutation status, CD38/ZAP-70 expression, and chromosomal deletions (11q, 17p) offer improved risk assessment for tailored therapy.
Area of Science:
- Hematology
- Oncology
- Molecular Biology
Background:
- Traditional Rai and Binet staging for chronic lymphocytic leukemia (CLL) is becoming outdated.
- New prognostic markers are emerging to better stratify CLL patients.
- Immunoglobulin variable region heavy-chain gene mutational status is a key validated marker.
Purpose of the Study:
- To identify and evaluate novel prognostic markers for chronic lymphocytic leukemia (CLL).
- To assess the utility of surrogate markers for immunoglobulin gene mutational status.
- To determine the readiness of new markers for risk-adapted therapy.
Main Methods:
- Analysis of immunoglobulin variable region heavy-chain gene mutational status.
- Flow cytometry assays for CD38 and ZAP-70 expression.
- Fluorescent in-situ hybridization (FISH) for chromosomal aberrations (11q and 17p deletions).
Main Results:
- Immunoglobulin gene mutational status effectively segregates CLL into benign and malignant forms.
- CD38 and ZAP-70 expression show promise as surrogate markers but require standardization.
- Chromosomal deletions 11q and 17p are significant prognostic indicators.
- Multiple new markers are in various stages of clinical evaluation.
Conclusions:
- New prognostic markers, including gene mutation status and chromosomal aberrations, are crucial for CLL management.
- Some markers are ready for implementation in risk-adapted therapeutic strategies.
- Further validation and standardization are needed for flow cytometry-based markers.
