PMID- 22171799
OWN - NLM
STAT- MEDLINE
DCOM- 20120430
LR  - 20171116
IS  - 1365-2141 (Electronic)
IS  - 0007-1048 (Linking)
VI  - 156
IP  - 4
DP  - 2012 Feb
TI  - Defining the prognosis of early stage chronic lymphocytic leukaemia patients.
PG  - 499-507
LID - 10.1111/j.1365-2141.2011.08974.x [doi]
AB  - Approximately 70% of chronic lymphocytic leukaemia (CLL) patients present with 
      early stage disease, therefore defining which patients will progress and require 
      treatment is a major clinical challenge. Here, we present the largest study of 
      prognostic markers ever carried out in Binet stage A patients (n = 1154) with a 
      median follow-up of 8 years. We assessed the prognostic impact of lymphocyte 
      doubling time (LDT), immunoglobulin gene (IGHV) mutation status, CD38 expression, 
      ZAP-70 expression and fluorescence in situ hybridization (FISH) cytogenetics with 
      regards to time to first treatment (TTFT) and overall survival (OS). Univariate 
      analysis revealed LDT as the most prognostic parameter for TTFT, with IGHV 
      mutation status most prognostic for OS. CD38 expression, ZAP-70 expression and 
      FISH were also prognostic variables; combinations of these markers increased 
      prognostic power in concordant cases. Multivariate analysis revealed that only 
      LDT, IGHV mutation status, CD38 and age at diagnosis were independent prognostic 
      variables for TTFT and OS. Therefore, IGHV mutation status and CD38 expression 
      have independent prognostic value in early stage CLL and should be performed as 
      part of the routine diagnostic workup. ZAP-70 expression and FISH were not 
      independent prognostic markers in early stage disease and can be omitted at 
      diagnosis but FISH analysis should be undertaken at disease progression to direct 
      treatment strategy.
CI  - (c) 2011 Blackwell Publishing Ltd.
FAU - Pepper, Chris
AU  - Pepper C
AD  - School of Medicine, Cardiff University, Cardiff, UK.
FAU - Majid, Aneela
AU  - Majid A
FAU - Lin, Thet Thet
AU  - Lin TT
FAU - Hewamana, Saman
AU  - Hewamana S
FAU - Pratt, Guy
AU  - Pratt G
FAU - Walewska, Renata
AU  - Walewska R
FAU - Gesk, Stefan
AU  - Gesk S
FAU - Siebert, Reiner
AU  - Siebert R
FAU - Wagner, Simon
AU  - Wagner S
FAU - Kennedy, Ben
AU  - Kennedy B
FAU - Miall, Fiona
AU  - Miall F
FAU - Davis, Zadie A
AU  - Davis ZA
FAU - Tracy, Ian
AU  - Tracy I
FAU - Gardiner, Anne C
AU  - Gardiner AC
FAU - Brennan, Paul
AU  - Brennan P
FAU - Hills, Robert K
AU  - Hills RK
FAU - Dyer, Martin J S
AU  - Dyer MJ
FAU - Oscier, David
AU  - Oscier D
FAU - Fegan, Chris
AU  - Fegan C
LA  - eng
PT  - Journal Article
DEP - 20111215
PL  - England
TA  - Br J Haematol
JT  - British journal of haematology
JID - 0372544
RN  - 0 (Immunoglobulin Variable Region)
RN  - EC 2.7.10.2 (ZAP-70 Protein-Tyrosine Kinase)
RN  - EC 3.2.2.6 (ADP-ribosyl Cyclase 1)
SB  - IM
MH  - ADP-ribosyl Cyclase 1/*genetics
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Gene Expression Regulation, Leukemic
MH  - Humans
MH  - Immunoglobulin Variable Region/*genetics
MH  - Kaplan-Meier Estimate
MH  - Leukemia, Lymphocytic, Chronic, B-Cell/*genetics/mortality/pathology
MH  - Middle Aged
MH  - Mutation
MH  - Neoplasm Staging
MH  - Prognosis
MH  - Time Factors
MH  - Young Adult
MH  - ZAP-70 Protein-Tyrosine Kinase/*genetics
EDAT- 2011/12/17 06:00
MHDA- 2012/05/01 06:00
CRDT- 2011/12/17 06:00
PHST- 2011/12/17 06:00 [entrez]
PHST- 2011/12/17 06:00 [pubmed]
PHST- 2012/05/01 06:00 [medline]
AID - 10.1111/j.1365-2141.2011.08974.x [doi]
PST - ppublish
SO  - Br J Haematol. 2012 Feb;156(4):499-507. doi: 10.1111/j.1365-2141.2011.08974.x. 
      Epub 2011 Dec 15.