Percentage of smudge cells determined on routine blood smears is a novel prognostic factor in chronic lymphocytic leukemia
Percentage of smudge cells determined on routine blood smears is a novel prognostic factor in chronic lymphocytic leukemia
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DOI：
10.1016/j.leukres.2010.02.038
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发表时间：
2010-07-01
影响因子：
2.7
通讯作者：
Nueckel, H.
中科院分区：
文献类型：
--
作者：
Johansson, P.;Eisele, L.;Nueckel, H.
最近开发的分子预后测试在早期Binet阶段的慢性淋巴细胞白血病（B-CLL）的患者是昂贵的，往往需要高水平的技术专长。最近的数据为B-CLL中污迹细胞百分比的预后相关性提供了证据。在我们的研究中，我们分析了这种新标记物在100例CLL患者队列中的预后潜力。污迹细胞的百分比范围为0%至70%（中位数为21%）。20%的患者有污迹细胞。多变量考克斯回归分析确定污迹细胞百分比、根据Binet的分期和CD 38表达为独立的预后标志物。CD 38+、ZAP-70+和未突变IgVH患者中污迹细胞的百分比显著较低。联合分析污迹细胞百分比与CD 38表达提供了补充的预后信息，确定三个患者亚组的良好，中等和不良预后。比较12名患者的亚组中的基因表达谱，我们在具有高与低百分比污迹细胞的组中鉴定了8个差异表达的基因，这表明这些差异表达的基因，特别是Tribbles同源物2（Trib 2），在高风险CLL患者的疾病进展中的作用。我们的数据证实了以前的研究，表明用于常规诊断目的的血涂片上污迹细胞的简单和廉价的显微镜检测是预测CLL总存活率的新的独立因素。(C)2010爱思唯尔有限公司保留所有权利。
Recently developed molecular prognostic tests in patients with early Binet stage chronic lymphocytic leukemia (B-CLL) are costly and often require a high level of technologic expertise. Recent data give evidence for the prognostic relevance of the percentage of smudge cells in B-CLL. In our study we analysed the prognostic potential of this novel marker in a cohort of 100 CLL patients. The percentage of smudge cells ranged from 0% to 70% (median 21%). Patients with 20% smudge cells. Multivariate Cox regression analysis identified percentages of smudge cells, stage according to Binet and CD38 expression as independent prognostic markers. The percentage of smudge cells was significantly lower in CD38+, ZAP-70+ and unmutated IgVH patients. Combined analysis of smudge cell percentages with CD38 expression provided complementary prognostic information identifying three patient subgroups with good, intermediate and poor prognosis. Comparing gene expression profiles in a subset of 12 patients we identified eight differentially expressed genes in groups with high vs. low percentage of smudge cells suggesting a role of these differentially expressed genes, especially for Tribbles homolog 2 (Trib2), in the disease progression of high risk CLL patients.In conclusion, our data confirm previous studies showing that the simple and inexpensive microscopic detection of smudge cells on blood smears prepared for routine diagnostic purposes is a novel independent factor predicting overall survival in CLL. (C) 2010 Elsevier Ltd. All rights reserved.