Chronic lymphocytic leukaemia with 17p deletion: a retrospective analysis of prognostic factors and therapy results
Por:
Delgado, J, Espinet, B, Oliveira, AC, Abrisqueta, P, de la Serna, J, Collado, R, Loscertales, J, Lopez, M, Hernandez-Rivas, JA, Ferra, C, Ramirez, A, Roncero, JM, Lopez, C, Aventin, A, Puiggros, A, Abella, E, Carbonell, F, Costa, D, Carrio, A, Gonzalez, M
Publicada:
1 abr 2012
Resumen:
Patients with chronic lymphocytic leukaemia (CLL) whose tumour cells harbour a 17p deletion (17p-) are universally considered to have a poor prognosis. The deletion can be detected at diagnosis or during the evolution of the disease, particularly in patients who have received chemotherapy. We sought to evaluate the natural history of patients with 17p- CLL, identify predictive factors within this prognostic subgroup, and evaluate the results of different therapeutic approaches. Data from 294 patients with 17p- CLL followed up at 20 different institutions was retrospectively collected and analysed. Median age was 68 (range 2798) years at the time of fluorescence in situ hybridization analysis. After 17p- documentation, 52% received treatment, achieving an overall response rate of 50%. Median overall survival was 41 months, and was significantly shorter in patients with elevated beta2-microglobulin concentration (P < 00 001), B symptoms ( P = 0 016), higher percentage of cells with deletion ( P < 0 001), and acquired deletions ( P = 0 012). These findings suggest that patients with 17p- CLL have a variable prognosis that can be refined using simple clinical and laboratory features, including 17p- clone size, beta2- microglobulin concentration, presence of B symptoms and type of deletion ( de novo versus acquired).
Filiaciones:
Delgado, J:
Univ Barcelona, Dept Haematol, Inst Haematol & Oncol, Hosp Clin,IDIBAPS, E-08036 Barcelona, Spain
Hosp Santa Creu & Sant Pau, Barcelona, Spain
Espinet, B:
Hosp Mar, Barcelona, Spain
Oliveira, AC:
Hosp Duran & Reynals, Barcelona, Spain
Abrisqueta, P:
Hosp Gen Valle Hebron, Barcelona, Spain
de la Serna, J:
Hosp 12 Octubre, E-28041 Madrid, Spain
Collado, R:
Gen Hosp, Valencia, Spain
Loscertales, J:
Hosp La Princesa, Madrid, Spain
Lopez, M:
Hosp Principe Asturias, Madrid, Spain
Hernandez-Rivas, JA:
Hosp Infanta Leonor, Madrid, Spain
Ferra, C:
Hosp Badalona Germans Trias & Pujol, Badalona, Spain
Ramirez, A:
Univ Oviedo, Hosp Cent Asturias, E-33080 Oviedo, Spain
Roncero, JM:
Hosp Josep Trueta, Girona, Spain
Aventin, A:
Hosp Santa Creu & Sant Pau, Barcelona, Spain
Puiggros, A:
Hosp Mar, Barcelona, Spain
Abella, E:
Hosp Mar, Barcelona, Spain
Carbonell, F:
Gen Hosp, Valencia, Spain
Gonzalez, M:
Hosp Clin Salamanca, Salamanca, Spain
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