“IDENTIFYING HIGH-RISK CHRONIC LYMPHOCYTIC LEUKEMIA: A PATHOGENESIS-ORIENTED APPRAISAL OF PROGNOSTIC AND PREDICTIVE FACTORS IN PATIENTS TREATED WITH CHEMOTHERAPY WITH OR WITHOUT IMMUNOTHERAPY.”

Sara Martinelli, Antonio Cuneo, Gian Matteo Rigolin
  • Sara Martinelli
    Univrersità di Ferrara,
  • Antonio Cuneo
    Univrersità di Ferrara, Italy | cut@unife.it
  • Gian Matteo Rigolin
    Univrersità di Ferrara,

Abstract

 

Chronic lymphocytic leukemia (CLL) displays an extremely variable clinical behaviour. Accurate prognostication and prediction of response to treatment is important in an era of effective first-line regimens and novel molecules for high risk patients. Because a plethora of prognostic biomarkers were identified, but few of them were validated by multivariable analysis in comprehensive prospective studies, we applied in this survey stringent criteria to select papers from the literature in order to identify the most reproducible prognostic/predictive markers. Each biomarker was analysed in terms of reproducibility across the different studies with respect to its impact on time to first treatment (TTFT), progression free survival (PFS), overall survival (OS), response to treatment and transformation into Richter’s syndrome (RS). We were able to identify the following biomarkers as the most reliable in guiding risk stratification in the daily clinical practice: 17p-/TP53 mutations, IGHV unmutated configuration, short telomeres and 11q-. However, the method for measuring telomere length was not validated yet and 11q- was predictive of inferior OS only in those patients who did not receive FCR-like combinations. Stage and lymphocytosis were predictive of shorter TTFT and age, high serum thymidine kinase levels and poor performance status were predictive of shorter OS. Using our stringent criteria no parameter was found to independently predict for inferior response to treatment or development of RS.  

Keywords

Chronic lymphocytic leukemia ,Prognostic Factors; Cytogenetics, New Therapies

Full Text:

PDF
HTML
Submitted: 2015-12-02 17:19:06
Published: 2016-10-15 00:00:00
Search for citations in Google Scholar
Related articles: Google Scholar
Abstract views:
835

Views:
PDF
160
HTML
1489

Article Metrics

Metrics Loading ...

Metrics powered by PLOS ALM


Copyright (c) 2016 Mediterranean Journal of Hematology and Infectious Diseases

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

 

The Mediterranean Journal of Hematology and Infectious Diseases [eISSN 2035-3006] is owned by the U.C.S.C. and it is published by PAGEPress®, Pavia, Italy. All credits and honors to PKP for their OJS.
 
 
© PAGEPress 2008-2017     -     PAGEPress is a registered trademark property of PAGEPress srl, Italy.     -     VAT: IT02125780185