Ig V gene mutation status and CD38 expression as novel prognostic indicators in chronic lymphocytic leukemia.
Ig V gene mutation status and CD38 expression as novel prognostic indicators in chronic lymphocytic leukemia.
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DOI：
10.1182/blood.v94.6.1840.418k06_1840_1847
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发表时间：
1999-09
期刊：
影响因子：
20.3
通讯作者：
R. Damle;T. Wasil;F. Fais;F. Ghiotto;A. Valetto;S. L. Allen;A. Buchbinder;D. Budman;K. Dittmar;J. Kolitz;S. Lichtman;P. Schulman;V. Vinciguerra;K. Rai;M. Ferrarini;N. Chiorazzi
中科院分区：
文献类型：
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作者：
R. Damle;T. Wasil;F. Fais;F. Ghiotto;A. Valetto;S. L. Allen;A. Buchbinder;D. Budman;K. Dittmar;J. Kolitz;S. Lichtman;P. Schulman;V. Vinciguerra;K. Rai;M. Ferrarini;N. Chiorazzi
对一组随机选择的IgM（+）B-慢性淋巴细胞白血病（B-CLL）病例进行细胞免疫表型研究，其中IG V（H）和V（L）基因序列可用。根据V基因突变状态和CD 38表达对病例进行分类，并分析治疗史和生存期。B-CLL可分为两组。与CD 38（+）细胞百分比较低的V基因突变患者相比（>/=30%），V基因未突变患者的CD 38（+）B-CLL细胞百分比较高（>/= 30%），CD 38（+）组对连续多方案化疗（包括氟达拉滨）反应较差，生存期较短。与此相反，突变型和/= 30%CD 38（+）组中，男性占明显优势，因此，IG V基因突变状态和CD 38（+）B-CLL细胞百分比似乎是B-CLL患者临床结局的准确预测因子。这些参数，特别是CD 38的表达，可以方便地在大多数临床实验室分析，应该是有价值的参数，目前的分期系统预测的临床过程中，个别B-CLL的情况。未来对新的治疗策略和药物的评估应该考虑到以这些方式分类的患者的不同自然史。
Cellular immunophenotypic studies were performed on a cohort of randomly selected IgM(+) B-chronic lymphocytic leukemia (B-CLL) cases for which Ig V(H) and V(L) gene sequences were available. The cases were categorized based on V gene mutation status and CD38 expression and analyzed for treatment history and survival. The B-CLL cases could be divided into 2 groups. Those patients with unmutated V genes displayed higher percentages of CD38(+) B-CLL cells (>/=30%) than those with mutated V genes that had lower percentages of CD38(+) cells (/=30% CD38(+) groups responded poorly to continuous multiregimen chemotherapy (including fludarabine) and had shorter survival. In contrast, the mutated and the /=30% CD38(+) groups, a marked male predominance was found. Thus, Ig V gene mutation status and the percentages of CD38(+) B-CLL cells appear to be accurate predictors of clinical outcome in B-CLL patients. These parameters, especially CD38 expression that can be analyzed conveniently in most clinical laboratories, should be valuable adjuncts to the present staging systems for predicting the clinical course in individual B-CLL cases. Future evaluations of new therapeutic strategies and drugs should take into account the different natural histories of patients categorized in these manners.