[Expression of stereotyped B-cell receptor and its clinical value in chronic lymphocytic leukemia]

To investigate the expression pattern of stereotyped B-cell receptor (BCR) and its prognostic significance in Chinese chronic lymphocytic leukemia (CLL) patients and evaluate the relationship to other prognostic markers.

Multiplex polymerase chain reaction (PCR) was used to identify the immunoglobulin variable heavy-chain (IGHV) segment and its mutation status in 116 CLL patients from April 1992 to April 2010. For CDR3-driven clustering, all in-frame IGHV-D-J rearrangements were aligned by the multiple sequence alignment software ClustalW2.

There were 102 of 116 samples from newly diagnosed CLL were successfully analyzed. IGHV CDR3 genes were identified in 73/102 cases. Fourteen patients (19.2%) carried stereotyped BCR. A high percentage of carried stereotyped BCR was observed in IGHV non-mutated group versus mutated group (40.9% vs 11.8%, P = 0.005). Patients with stereotyped BCR had a higher frequency of deletion (17q) (33.3% vs 10.7%, P = 0.045). The median progression-free survival (PFS) in patients with stereotyped BCR was much shorter than other patients (39 vs 84 months, P = 0.002).

The patients with stereotyped BCR have a poor prognosis. It highlights the importance of immunoglobulin mediated stimulation in the development of CLL.