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Isik S, Gunden G, Gunduz E, Akay OM, Aslan A, Ozen H, Cilingir O, Erzurumluoglu Gokalp E, Kocagil S, Artan S, Gulbas Z, Durak Aras B. An Anomaly with Potential as a New Prognostic Marker in CLL with del(13q): Gain of 16p13.3. Cytogenet Genome Res 2021; 161:479-487. [PMID: 34915466 DOI: 10.1159/000520242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 10/15/2021] [Indexed: 11/19/2022] Open
Abstract
Deletion 13q [del(13q)] is a favorable prognostic marker if it is detected as a sole abnormality in chronic lymphocytic leukemia (CLL). However the clinical courses of cases with isolated del(13q) are quite heterogeneous. In our study, we investigated copy number variations (CNVs), loss of heterozygosity (LOH), and the size of del(13q) in 30 CLL patients with isolated del(13q). We used CGH+SNP microarrays in order to understand the cause of this clinical heterogeneity. We detected del(13q) in 28/30 CLL cases. The size of the deletion varied from 0.34 to 28.81 Mb, and there was no clinical effect of the deletion size. We found new prognostic markers, especially the gain of 16p13.3. These markers have statistically significant associations with short time to first treatment and advanced disease stage. Detecting both CNVs and LOH at the same time is an advantageous feature of aCGH+SNP. However, it is very challenging for the array analysis to detect mosaic anomalies. Therefore, it is very important to confirm the results by FISH. In our study, we detected approximately 9% mosaic del(13q) by microarray. In addition, the gain of 16p13.3 may affect the disease prognosis in CLL. However, additional studies with more patients are needed to confirm these results.
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Affiliation(s)
- Sevgi Isik
- Department of Medical Genetics, Faculty of Medicine, University of Eskisehir Osmangazi, Eskisehir, Turkey
| | - Gulcin Gunden
- Department of Medical Genetics, Faculty of Medicine, University of Eskisehir Osmangazi, Eskisehir, Turkey
| | - Eren Gunduz
- Department of Hematology, Faculty of Medicine, University of Eskisehir Osmangazi, Eskisehir, Turkey
| | - Olga Meltem Akay
- Department of Hematology, Faculty of Medicine, University of Koc, Istanbul, Turkey
| | - Abdulvahap Aslan
- Department of Hematology, Private Umit Hospital, Eskisehir, Turkey
| | - Hulya Ozen
- Department of Biostatistics, Faculty of Medicine, University of Eskisehir Osmangazi, Eskisehir, Turkey
| | - Oguz Cilingir
- Department of Medical Genetics, Faculty of Medicine, University of Eskisehir Osmangazi, Eskisehir, Turkey
| | - Ebru Erzurumluoglu Gokalp
- Department of Medical Genetics, Faculty of Medicine, University of Eskisehir Osmangazi, Eskisehir, Turkey
| | - Sinem Kocagil
- Department of Medical Genetics, Faculty of Medicine, University of Eskisehir Osmangazi, Eskisehir, Turkey
| | - Sevilhan Artan
- Department of Medical Genetics, Faculty of Medicine, University of Eskisehir Osmangazi, Eskisehir, Turkey
| | - Zafer Gulbas
- Department of Hematology, Anadolu Medical Center, İzmit, Turkey
| | - Beyhan Durak Aras
- Department of Medical Genetics, Faculty of Medicine, University of Eskisehir Osmangazi, Eskisehir, Turkey.,Translational Medicine Research and Clinical Center, University of Eskisehir Osmangazi, Eskisehir, Turkey
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Khalid K, Padda J, Syam M, Moosa A, Kakani V, Sanka S, Zubair U, Padda S, Cooper AC, Jean-Charles G. 13q14 Deletion and Its Effect on Prognosis of Chronic Lymphocytic Leukemia. Cureus 2021; 13:e16839. [PMID: 34522485 PMCID: PMC8424995 DOI: 10.7759/cureus.16839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2021] [Indexed: 11/29/2022] Open
Abstract
Chronic lymphocytic leukemia (CLL) is the most common leukemia affecting adults. CLL results due to uncontrolled accumulation of B lymphocytes in the body with the clinical spectrum ranging from comparatively benign disease to an aggressive form. The disease pathogenesis lies in molecular genetics, the most common alteration being the deletion in the long arm of chromosome 13, at position 14 (13q14) region. This deletion leads to the loss of important microRNAs which are involved in maintaining the critical balance of the apoptosis mechanism of cell death of B lymphocytes. As such, the imbalance contributes towards B cells' immortality and, thus, CLL arises. This significant 13q14 deletion contributes to CLL's pathogenesis and paves the way for CLL treatment, hence affecting the prognosis of the affected patients. Furthermore, the size of deletion of the long arm of chromosome 13 (13q) has a remarkable effect on its prognosis and therapeutic intervention. The minimal deleted region (MDR)/small deletion or long 13q loss/mutation, and biallelic 13q deletion or monoallelic 13q deletion are commonly seen. 13q14 deletion is an initiating defect targeting tumor suppressor gene locus deleted in lymphocytic leukemia 2 (DLEU2))/microRNA15A (MIR15A)/microRNA 16-1 (MIR 16-1). Regarding CLL treatment, conventional therapy with alkylating agents has been used for a long time, which reported low- to non-existent complete remission rates and adverse events after prolonged use. Moreover, research into the 13q14 deletion has also provided new insights into the molecular genetics and pathways that interact in such a way, making it possible to transform healthy cells into malignant cells in an entirely new fashion with a complete disregard to its original form, resulting in CLL.
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Affiliation(s)
| | - Jaskamal Padda
- Internal Medicine, JC Medical Center, Orlando, USA.,Internal Medicine, Avalon University School of Medicine, Willemstad, CUW
| | | | - Amir Moosa
- Internal Medicine, JC Medical Center, Orlando, USA
| | - Varsha Kakani
- Internal Medicine, Kakatiya Medical College, Warangal, IND
| | - Sujana Sanka
- Internal Medicine, JC Medical Center, Orlando, USA
| | - Ujala Zubair
- Family Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Sandeep Padda
- Internal Medicine, JC Medical Center, Orlando, USA.,Internal Medicine, Avalon University School of Medicine, Willemstad, CUW
| | | | - Gutteridge Jean-Charles
- Internal Medicine, Advent Health and Orlando Health Hospital/JC Medical Center, Orlando, USA
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3
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Pérez-Carretero C, González-Gascón-y-Marín I, Rodríguez-Vicente AE, Quijada-Álamo M, Hernández-Rivas JÁ, Hernández-Sánchez M, Hernández-Rivas JM. The Evolving Landscape of Chronic Lymphocytic Leukemia on Diagnosis, Prognosis and Treatment. Diagnostics (Basel) 2021; 11:diagnostics11050853. [PMID: 34068813 PMCID: PMC8151186 DOI: 10.3390/diagnostics11050853] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/25/2021] [Accepted: 05/05/2021] [Indexed: 12/22/2022] Open
Abstract
The knowledge of chronic lymphocytic leukemia (CLL) has progressively deepened during the last forty years. Research activities and clinical studies have been remarkably fruitful in novel findings elucidating multiple aspects of the pathogenesis of the disease, improving CLL diagnosis, prognosis and treatment. Whereas the diagnostic criteria for CLL have not substantially changed over time, prognostication has experienced an expansion with the identification of new biological and genetic biomarkers. Thanks to next-generation sequencing (NGS), an unprecedented number of gene mutations were identified with potential prognostic and predictive value in the 2010s, although significant work on their validation is still required before they can be used in a routine clinical setting. In terms of treatment, there has been an impressive explosion of new approaches based on targeted therapies for CLL patients during the last decade. In this current chemotherapy-free era, BCR and BCL2 inhibitors have changed the management of CLL patients and clearly improved their prognosis and quality of life. In this review, we provide an overview of these novel advances, as well as point out questions that should be further addressed to continue improving the outcomes of patients.
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Affiliation(s)
- Claudia Pérez-Carretero
- Cancer Research Center (IBMCC) CSIC-University of Salamanca, 37007 Salamanca, Spain; (C.P.-C.); (A.E.R.-V.); (M.Q.-Á.)
- Instituto de Investigación Biomédica (IBSAL), 37007 Salamanca, Spain
- Department of Hematology, University Hospital of Salamanca, 37007 Salamanca, Spain
| | | | - Ana E. Rodríguez-Vicente
- Cancer Research Center (IBMCC) CSIC-University of Salamanca, 37007 Salamanca, Spain; (C.P.-C.); (A.E.R.-V.); (M.Q.-Á.)
- Instituto de Investigación Biomédica (IBSAL), 37007 Salamanca, Spain
- Department of Hematology, University Hospital of Salamanca, 37007 Salamanca, Spain
| | - Miguel Quijada-Álamo
- Cancer Research Center (IBMCC) CSIC-University of Salamanca, 37007 Salamanca, Spain; (C.P.-C.); (A.E.R.-V.); (M.Q.-Á.)
- Instituto de Investigación Biomédica (IBSAL), 37007 Salamanca, Spain
- Department of Hematology, University Hospital of Salamanca, 37007 Salamanca, Spain
| | - José-Ángel Hernández-Rivas
- Department of Hematology, Infanta Leonor University Hospital, 28031 Madrid, Spain; (I.G.-G.-y-M.); (J.-Á.H.-R.)
- Department of Medicine, Complutense University, 28040 Madrid, Spain
| | - María Hernández-Sánchez
- Cancer Research Center (IBMCC) CSIC-University of Salamanca, 37007 Salamanca, Spain; (C.P.-C.); (A.E.R.-V.); (M.Q.-Á.)
- Instituto de Investigación Biomédica (IBSAL), 37007 Salamanca, Spain
- Department of Hematology, University Hospital of Salamanca, 37007 Salamanca, Spain
- Correspondence: (M.H.-S.); (J.M.H.-R.); Tel.: +34-923-294-812 (M.H.-S. & J.M.H.-R.)
| | - Jesús María Hernández-Rivas
- Cancer Research Center (IBMCC) CSIC-University of Salamanca, 37007 Salamanca, Spain; (C.P.-C.); (A.E.R.-V.); (M.Q.-Á.)
- Instituto de Investigación Biomédica (IBSAL), 37007 Salamanca, Spain
- Department of Hematology, University Hospital of Salamanca, 37007 Salamanca, Spain
- Department of Medicine, University of Salamanca, 37008 Salamanca, Spain
- Correspondence: (M.H.-S.); (J.M.H.-R.); Tel.: +34-923-294-812 (M.H.-S. & J.M.H.-R.)
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From Biomarkers to Models in the Changing Landscape of Chronic Lymphocytic Leukemia: Evolve or Become Extinct. Cancers (Basel) 2021; 13:cancers13081782. [PMID: 33917885 PMCID: PMC8068228 DOI: 10.3390/cancers13081782] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 03/27/2021] [Accepted: 04/05/2021] [Indexed: 12/23/2022] Open
Abstract
Simple Summary Chronic lymphocytic leukemia (CLL) is characterized by a highly variable clinical course. Thus, predicting the outcome of patients with this disease is a topic of special interest. The rapidly changing treatment landscape of CLL has questioned the value of classical biomarkers and prognostic models. Herein we examine the current state-of-the-art of prognostic and predictive biomarkers in the setting of new oral targeted agents with special focus on the most controversial findings over the last years. We also discuss the available information on the role of “old” and “new” prognostic models in the era of oral small molecules. Abstract Chronic lymphocytic leukemia (CLL) is an extremely heterogeneous disease. With the advent of oral targeted agents (Tas) the treatment of CLL has undergone a revolution, which has been accompanied by an improvement in patient’s survival and quality of life. This paradigm shift also affects the value of prognostic and predictive biomarkers and prognostic models, most of them inherited from the chemoimmunotherapy era but with a different behavior with Tas. This review discusses: (i) the role of the most relevant prognostic and predictive biomarkers in the setting of Tas; and (ii) the validity of classic and new scoring systems in the context of Tas. In addition, a critical point of view about predictive biomarkers with special emphasis on 11q deletion, novel resistance mutations, TP53 abnormalities, IGHV mutational status, complex karyotype and NOTCH1 mutations is stated. We also go over prognostic models in early stage CLL such as IPS-E. Finally, we provide an overview of the applicability of the CLL-IPI for patients treated with Tas, as well as the emergence of new models, generated with data from patients treated with Tas.
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5
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Durak Aras B, Isik S, Uskudar Teke H, Aslan A, Yavasoglu F, Gulbas Z, Demirkan F, Ozen H, Cilingir O, Inci NS, Gunden G, Bulduk T, Erzurumluoglu Gokalp E, Kocagil S, Artan S, Akay OM. Which prognostic marker is responsible for the clinical heterogeneity in CLL with 13q deletion? Mol Cytogenet 2021; 14:2. [PMID: 33407772 PMCID: PMC7788884 DOI: 10.1186/s13039-020-00522-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 12/09/2020] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Deletion of 13q14 [del(13q)] is the most common cytogenetic change (50%) in chronic lymphoblastic leukemia (CLL), and it is a good prognostic factor if it is detected as a sole aberration by FISH. However, it is observed the clinical course of CLL cases with del(13q) are quite heterogeneous and the responsible for this clinical heterogeneity has not been established yet. Some investigators suggest type II deletion (include RB1 gene) is associated with more aggressive clinical course. Also, it is suggested that the deletion burden and the deletion type have a prognostic effect. In this study, we aimed to investigate the effect of RB1 gene deletion, deletion burden and deletion type on overall survival (OS), disease stage and time to first treatment (TTFT) in patients with isolated del(3q). Sixty eight cases, detected isolated del(13q) were included in the study. Also, RB1 deletion was analyzed from peripheral blood of them using FISH. RESULTS RB1 deletion was detected in 41% of patients, but there was no statistically significant difference between RB1 deletion and TTFT, stage and OS (p > 0.05). At same time, statistically significant difference was detected between high del(13q) (> 80%) and TTFT (p < 0.05). CONCLUSION The statistical analysis of our data regarding to the association between RB1 deletion and deletion type, TTFT, disease stage, and OS has not confirmed type II deletion or biallelic deletion cause poor prognosis. However, our data supports the deletion burden has a prognostic effect. More studies are needed to elucidate the cause of the clinical heterogeneity of CLL cases with del(13q).
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Affiliation(s)
- Beyhan Durak Aras
- Department of Medical Genetics, Faculty of Medicine, University of Eskisehir Osmangazi, Professor Dr. Nabi Avcı Street, No. 4, Eskisehir, Buyukdere, 26040, Turkey.
| | - Sevgi Isik
- Department of Medical Genetics, Faculty of Medicine, University of Eskisehir Osmangazi, Professor Dr. Nabi Avcı Street, No. 4, Eskisehir, Buyukdere, 26040, Turkey
| | - Hava Uskudar Teke
- Department of Hematology, Faculty of Medicine, University of Eskisehir Osmangazi, Eskisehir, Turkey
| | - Abdulvahap Aslan
- Department of Hematology, Private Umit Hospital, Eskisehir, Turkey
| | - Filiz Yavasoglu
- Department of Hematology, Faculty of Medicine, University of Afyonkarahisar Health Sciences, Afyon, Turkey
| | - Zafer Gulbas
- Department of Hematology, Anadolu Medical Center, Kocaeli, Turkey
| | - Fatih Demirkan
- Department of Oncology, Faculty of Medicine, University of Dokuz Eylul, Izmir, Turkey
| | - Hulya Ozen
- Department of Biostatistics, Faculty of Medicine, University of Eskisehir Osmangazi, Eskisehir, Turkey
| | - Oguz Cilingir
- Department of Medical Genetics, Faculty of Medicine, University of Eskisehir Osmangazi, Professor Dr. Nabi Avcı Street, No. 4, Eskisehir, Buyukdere, 26040, Turkey
| | - Nur Sena Inci
- Department of Medical Genetics, Faculty of Medicine, University of Eskisehir Osmangazi, Professor Dr. Nabi Avcı Street, No. 4, Eskisehir, Buyukdere, 26040, Turkey
| | - Gulcin Gunden
- Department of Medical Genetics, Faculty of Medicine, University of Eskisehir Osmangazi, Professor Dr. Nabi Avcı Street, No. 4, Eskisehir, Buyukdere, 26040, Turkey
| | - Tuba Bulduk
- Department of Hematology, Faculty of Medicine, University of Eskisehir Osmangazi, Eskisehir, Turkey
| | - Ebru Erzurumluoglu Gokalp
- Department of Medical Genetics, Faculty of Medicine, University of Eskisehir Osmangazi, Professor Dr. Nabi Avcı Street, No. 4, Eskisehir, Buyukdere, 26040, Turkey
| | - Sinem Kocagil
- Department of Medical Genetics, Faculty of Medicine, University of Eskisehir Osmangazi, Professor Dr. Nabi Avcı Street, No. 4, Eskisehir, Buyukdere, 26040, Turkey
| | - Sevilhan Artan
- Department of Medical Genetics, Faculty of Medicine, University of Eskisehir Osmangazi, Professor Dr. Nabi Avcı Street, No. 4, Eskisehir, Buyukdere, 26040, Turkey
| | - Olga Meltem Akay
- Department of Hematology, Faculty of Medicine, University of Koc, Istanbul, Turkey
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6
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Condoluci A, Rossi D. Genetic mutations in chronic lymphocytic leukemia: impact on clinical treatment. Expert Rev Hematol 2019; 12:89-98. [DOI: 10.1080/17474086.2019.1575130] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Adalgisa Condoluci
- Division of Hematology, Oncology Institute of Southern Switzerland and Laboratory of Experimental Hematology, Institute of Oncology Research, Bellinzona, Switzerland
| | - Davide Rossi
- Division of Hematology, Oncology Institute of Southern Switzerland and Laboratory of Experimental Hematology, Institute of Oncology Research, Bellinzona, Switzerland
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Miao Y, Miao Y, Shi K, Sun Q, Zhao SS, Xia Y, Qin SC, Qiu HR, Yang H, Xu H, Zhu HY, Wu JZ, Wu W, Cao L, Wang L, Fan L, Xu W, Li JY. A higher percentage of cells with 13q deletion predicts worse outcome in Chinese patients with chronic lymphocytic leukemia carrying isolated 13q deletion. Ann Hematol 2018; 97:1663-1669. [PMID: 29736587 DOI: 10.1007/s00277-018-3359-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Accepted: 04/28/2018] [Indexed: 01/05/2023]
Abstract
Previous studies showed that, in chronic lymphocytic leukemia (CLL) patients with isolated 13q deletion (13q-), those carrying higher percentage of leukemic cells with 13q- had more aggressive diseases. However, the prognostic value of the percentage of leukemic cells with 13q- in Chinese CLL patients with isolated 13q- remained to be determined. Using interphase fluorescence in situ hybridization (FISH), we identified 82 patients (25.4%) with isolated 13q deletion from a cohort of 323 untreated CLL patients. Among patients with isolated 13q deletion, cases of 13q- cells ≥ 80% (13q-H) had significantly shorter time to first treatment (TTT) than those of < 80% 13q- cells (13q-L) (median 11 vs. 92 months, p = 0.0016). A higher lymphocyte count (p = 0.0650) was associated with 13q-H, while other clinical, immunophenotypic, or molecular features did not differ between patients with 13q-H and 13q-L. Although 13q-H only showed marginal significance in multivariate analysis of TTT (hazards ratio 2.007; 95% confidence interval 0.975-4.129; p = 0.059), it helped refine the risk stratification based on Binet stage or immunoglobulin heavy chain variable gene (IGHV) status. In cases in Binet A or B stage, patients with 13q-H had a significantly shorter TTT (median TTT 18 months vs. undefined, p = 0.0101). And in IGHV mutated patients, 13q-H was also associated with reduced TTT (median TTT 13q-H. 18 months vs. 13q-L undefined, p = 0.0163). In conclusion, the prognosis of CLL patients with isolated 13q deletion was heterogeneous with 13q-H identifying patients with worse outcome.
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Affiliation(s)
- Yuqing Miao
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.,Key Laboratory of Hematology of Nanjing Medical University, Nanjing, 210029, China.,Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, 210029, China.,Department of Hematology, The First People's Hospital of Yancheng, Yancheng, Jiangsu Province, China
| | - Yi Miao
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.,Key Laboratory of Hematology of Nanjing Medical University, Nanjing, 210029, China.,Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, 210029, China
| | - Ke Shi
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.,Key Laboratory of Hematology of Nanjing Medical University, Nanjing, 210029, China.,Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, 210029, China
| | - Qian Sun
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.,Key Laboratory of Hematology of Nanjing Medical University, Nanjing, 210029, China.,Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, 210029, China
| | - Si-Shu Zhao
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.,Key Laboratory of Hematology of Nanjing Medical University, Nanjing, 210029, China.,Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, 210029, China
| | - Yi Xia
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.,Key Laboratory of Hematology of Nanjing Medical University, Nanjing, 210029, China.,Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, 210029, China
| | - Shu-Chao Qin
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.,Key Laboratory of Hematology of Nanjing Medical University, Nanjing, 210029, China.,Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, 210029, China
| | - Hai-Rong Qiu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.,Key Laboratory of Hematology of Nanjing Medical University, Nanjing, 210029, China.,Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, 210029, China
| | - Hui Yang
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.,Key Laboratory of Hematology of Nanjing Medical University, Nanjing, 210029, China.,Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, 210029, China
| | - Hao Xu
- Department of Hematology, The First People's Hospital of Yancheng, Yancheng, Jiangsu Province, China
| | - Hua-Yuan Zhu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.,Key Laboratory of Hematology of Nanjing Medical University, Nanjing, 210029, China.,Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, 210029, China
| | - Jia-Zhu Wu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.,Key Laboratory of Hematology of Nanjing Medical University, Nanjing, 210029, China.,Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, 210029, China
| | - Wei Wu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.,Key Laboratory of Hematology of Nanjing Medical University, Nanjing, 210029, China.,Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, 210029, China
| | - Lei Cao
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.,Key Laboratory of Hematology of Nanjing Medical University, Nanjing, 210029, China.,Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, 210029, China
| | - Li Wang
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.,Key Laboratory of Hematology of Nanjing Medical University, Nanjing, 210029, China.,Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, 210029, China
| | - Lei Fan
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.,Key Laboratory of Hematology of Nanjing Medical University, Nanjing, 210029, China.,Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, 210029, China
| | - Wei Xu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China. .,Key Laboratory of Hematology of Nanjing Medical University, Nanjing, 210029, China. .,Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, 210029, China.
| | - Jian-Yong Li
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China. .,Key Laboratory of Hematology of Nanjing Medical University, Nanjing, 210029, China. .,Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, 210029, China.
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8
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Bagacean C, Le Dantec C, Berthou C, Tempescul A, Saad H, Bordron A, Zdrenghea M, Cristea V, Douet-Guilbert N, Renaudineau Y. Combining cytogenetic and epigenetic approaches in chronic lymphocytic leukemia improves prognosis prediction for patients with isolated 13q deletion. Clin Epigenetics 2017; 9:122. [PMID: 29209431 PMCID: PMC5704505 DOI: 10.1186/s13148-017-0422-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 11/17/2017] [Indexed: 11/10/2022] Open
Abstract
Background Both defective DNA methylation and active DNA demethylation processes are emerging as important risk factors in chronic lymphocytic leukemia (CLL). However, associations between 5-cytosine epigenetic markers and the most frequent chromosomal abnormalities detected in CLL remain to be established. Methods CLL patients were retrospectively classified into a cytogenetic low-risk group (isolated 13q deletion), an intermediate-risk group (normal karyotype or trisomy 12), and a high-risk group (11q deletion, 17p deletion, or complex karyotype [≥ 3 breakpoints]). The two 5-cytosine derivatives, 5-methylcytosine (5-mCyt) and 5-hydroxymethylcytosine (5-hmCyt), were tested by ELISA (n = 60), while real-time quantitative PCR was used for determining transcriptional expression levels of DNMT and TET (n = 24). Results By using global DNA methylation/demethylation levels, in the low-risk disease group, two subgroups with significantly different clinical outcomes have been identified (median treatment-free survival [TFS] 45 versus > 120 months for 5-mCyt, p = 0.0008, and 63 versus > 120 months for 5-hmCyt, p = 0.04). A defective 5-mCyt status was further associated with a higher percentage of 13q deleted nuclei (> 80%), thus suggesting an acquired process. When considering the cytogenetic intermediate/high-risk disease groups, an association of 5-mCyt status with lymphocytosis (p = 0.0008) and the lymphocyte doubling time (p = 0.04) but not with TFS was observed, as well as a reduction of DNMT3A, TET1, and TET2 transcripts. Conclusions Combining cytogenetic studies with 5-mCyt assessment adds accuracy to CLL patients’ prognoses and particularly for those with 13q deletion as a sole cytogenetic abnormality.
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Affiliation(s)
- Cristina Bagacean
- U1227 B lymphocytes and autoimmunity, University of Brest, INSERM, IBSAM, Labex IGO, networks IC-CGO and REpiCGO from "Canceropole Grand Ouest", Brest, France.,Laboratory of Immunology and Immunotherapy, Brest University Medical School Hospital, BP 824, 29609 Brest, France.,"Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Christelle Le Dantec
- U1227 B lymphocytes and autoimmunity, University of Brest, INSERM, IBSAM, Labex IGO, networks IC-CGO and REpiCGO from "Canceropole Grand Ouest", Brest, France
| | - Christian Berthou
- U1227 B lymphocytes and autoimmunity, University of Brest, INSERM, IBSAM, Labex IGO, networks IC-CGO and REpiCGO from "Canceropole Grand Ouest", Brest, France.,Department of Hematology, Brest University Medical School Hospital, Brest, France
| | - Adrian Tempescul
- U1227 B lymphocytes and autoimmunity, University of Brest, INSERM, IBSAM, Labex IGO, networks IC-CGO and REpiCGO from "Canceropole Grand Ouest", Brest, France.,Department of Hematology, Brest University Medical School Hospital, Brest, France
| | - Hussam Saad
- Department of Hematology, Brest University Medical School Hospital, Brest, France
| | - Anne Bordron
- U1227 B lymphocytes and autoimmunity, University of Brest, INSERM, IBSAM, Labex IGO, networks IC-CGO and REpiCGO from "Canceropole Grand Ouest", Brest, France
| | - Mihnea Zdrenghea
- "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Department of Hematology, "Ion Chiricuta" Oncology Institute, Cluj-Napoca, Romania
| | - Victor Cristea
- "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | | | - Yves Renaudineau
- U1227 B lymphocytes and autoimmunity, University of Brest, INSERM, IBSAM, Labex IGO, networks IC-CGO and REpiCGO from "Canceropole Grand Ouest", Brest, France.,Laboratory of Immunology and Immunotherapy, Brest University Medical School Hospital, BP 824, 29609 Brest, France
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9
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Shukla A, Shukla V, Joshi SS. Regulation of MAPK signaling and implications in chronic lymphocytic leukemia. Leuk Lymphoma 2017; 59:1565-1573. [PMID: 28882083 DOI: 10.1080/10428194.2017.1370548] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Chronic lymphocytic leukemia (CLL) is a heterogeneous B cell malignancy that still remains incurable. Recent studies have highlighted cellular and non-cellular components of the tissue microenvironment in CLL that help nurture the growth of leukemic cells by providing the necessary stimuli for their proliferation and survival. The diverse stimuli in the specialized tissue microenvironment of CLL lead to constitutive activation of several signaling pathways that includes B cell receptor signaling and the associated mitogen-activated protein kinase (MAPK) signaling. Recent findings have described aberrant activation of MAPK signaling and its interactions with other cellular signaling pathways in the pathogenesis of CLL. These studies have shed light on the deregulated molecular mechanisms contributing to hyperactivation of MAPK signaling and provided avenues for therapeutic options for aggressive CLL. In this review, we describe and discuss the current status of our understanding into the role of MAPK signaling in the pathogenesis of CLL.
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Affiliation(s)
- Ashima Shukla
- a Sanford Burnham Prebys Medical Discovery Institute , La Jolla , CA , USA
| | - Vipul Shukla
- b La Jolla Institute for Allergy and Immunology , La Jolla , CA , USA
| | - Shantaram S Joshi
- c Department of Genetics Cell Biology and Anatomy , University of Nebraska Medical Centre , Omaha , NE , USA
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10
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González-Gascón Y Marín I, Hernández-Sanchez M, Rodríguez-Vicente AE, Puiggros A, Collado R, Luño E, González T, Ruiz-Xivillé N, Ortega M, Gimeno E, Muñoz C, Infante MS, Delgado J, Vargas MT, González M, Bosch F, Espinet B, Hernández-Rivas JM, Hernández JÁ. Characterizing patients with multiple chromosomal aberrations detected by FISH in chronic lymphocytic leukemia. Leuk Lymphoma 2017; 59:633-642. [PMID: 28728469 DOI: 10.1080/10428194.2017.1349901] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
We analyzed the features of chronic lymphocytic leukemia (CLL) with multiple abnormalities (MA) detected by FISH. A local database including 2095 CLL cases was used and 323 with MA (15.4%) were selected. MA was defined by the presence of two or more alterations (deletions of 13q14 (13q-), 11q22 (11q-), 17p13 (17p-) or trisomy 12 (+12)). The combination of 13q- with 11q- and 13q- with 17p-, accounted for 58.2% of the series, in contrast to 11q- with 17p- (3.7%). Patients carrying MA since diagnosis presented a short time to first therapy(TTFT) (27 months) and overall survival (OS) (76 months). The combinations including 17p- had a shorter OS (58 months) than the ones without 17p- (not reached, p = .002). Patients with a complex-FISH were the ones with worse OS (34 months). MA imply poor prognosis when they emerge at diagnosis, probably due to the high incidence of bad prognosis markers, which may be a reflection of a more complex karyotype.
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Affiliation(s)
- Isabel González-Gascón Y Marín
- a Hematolology Department , Hospital Universitario Infanta Leonor , Madrid , Spain.,b Medicine Department , Universidad Complutense de Madrid , Spain
| | - María Hernández-Sanchez
- c Centro de Investigación del Cáncer-IBMCC , Universidad de Salamanca (USAL-CSIC) , Salamanca , Spain
| | | | - Anna Puiggros
- d Laboratori de Citogenètica Molecular, Servei de Patologia, Servei D´Hematologia Clínica , Hospital del Mar , Barcelona , Spain.,e Grup de Recerca Translacional en Neoplàsies Hematològiques, Programa de Recerca en Càncer , Institut Hospital del Mar d'Investigacions Mèdiques (IMIM) , Barcelona , Spain
| | - Rosa Collado
- f Hematology Department , Consorcio Hospital General Universitario , Valencia , Spain
| | - Elisa Luño
- g Hematology Department , Hospital Universitario Central de Asturias , Oviedo , Spain
| | - Teresa González
- h Fundación Pública Galega de Medicina Xenómica , Santiago de Compostela , Spain
| | - Neus Ruiz-Xivillé
- i Laboratori Hematologia , ICO-Hospital Germans Trias i Pujol, Institut de Recerca Contra la Leucèmia Josep Carreras (IJC) , Spain
| | - Margarita Ortega
- j Hematology and Cytogenetics Departments , Hospital Vall d'Hebron , Barcelona , Spain
| | - Eva Gimeno
- d Laboratori de Citogenètica Molecular, Servei de Patologia, Servei D´Hematologia Clínica , Hospital del Mar , Barcelona , Spain
| | - Carolina Muñoz
- a Hematolology Department , Hospital Universitario Infanta Leonor , Madrid , Spain
| | | | - Julio Delgado
- k Hematology Department , Hospital Clinic and Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS) , Barcelona , Spain
| | - María Teresa Vargas
- l Hematology Department , Hospital Universitario Virgen de la Macarena , Sevilla , Spain
| | - Marcos González
- m Hematology Department , IBSAL-Hospital Universitario de Salamanca , Salamanca , Spain
| | - Francesc Bosch
- j Hematology and Cytogenetics Departments , Hospital Vall d'Hebron , Barcelona , Spain
| | - Blanca Espinet
- d Laboratori de Citogenètica Molecular, Servei de Patologia, Servei D´Hematologia Clínica , Hospital del Mar , Barcelona , Spain
| | - Jesús María Hernández-Rivas
- c Centro de Investigación del Cáncer-IBMCC , Universidad de Salamanca (USAL-CSIC) , Salamanca , Spain.,m Hematology Department , IBSAL-Hospital Universitario de Salamanca , Salamanca , Spain
| | - José Ángel Hernández
- a Hematolology Department , Hospital Universitario Infanta Leonor , Madrid , Spain.,b Medicine Department , Universidad Complutense de Madrid , Spain
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11
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Sandoval-Sus JD, Chavez JC, Dalia S, Naqvi SMH, Talati C, Nodzon L, Kharfan-Dabaja MA, Pinilla-Ibarz J. Association between immunoglobulin heavy-chain variable region mutational status and isolated favorable baseline genomic aberrations in chronic lymphocytic leukemia. Leuk Lymphoma 2017. [PMID: 28641468 DOI: 10.1080/10428194.2017.1323271] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Immunoglobulin heavy-chain variable region (IGHV) mutational status and karyotype abnormalities are important prognostic factors in chronic lymphocytic leukemia (CLL). The goal was to assess the impact of IGHV in CLL patients with isolated favorable genetic aberrations (del13q, trisomy 12, or negative fluorescence in situ hybridization [FISH]). We studied 273 CLL patients with both IGHV mutational status and cytogenetic information: 145 with isolated del13q 49 with sole trisomy 12 and 79 with negative FISH. After a median follow-up of 7.8 years, patients with del13q-unmutated IGHV had a shorter time to first treatment (TFT) (2.98 vs. 17.44 years; p < .001) and shorter overall survival (10.45 years vs. not reached; p = .0026). Patients with negative FISH-unmutated IGHV had shorter TFT (p = .02) (3.10 vs. 9.75 years, p = .053). IGHV status did not influence clinical outcomes in trisomy 12 CLL. In conclusion, IGHV mutational status shows prognostic impact in CLL patients with good prognosis genomic features.
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Affiliation(s)
- Jose D Sandoval-Sus
- a H. Lee Moffitt Cancer Center and Research Institute, University of South Florida , Tampa , FL , USA
| | - Julio C Chavez
- b Department of Malignant Hematology , H. Lee Moffitt Cancer Center and Research Institute , Tampa , FL , USA
| | - Samir Dalia
- c Mercy Clinic Oncology and Hematology , Joplin , MO , USA
| | - Syeda Mahrukh Hussnain Naqvi
- d Department of Biostatistics and Bioinformatics , H. Lee Moffitt Cancer Center and Research Institute , Tampa , FL , USA
| | - Chetasi Talati
- a H. Lee Moffitt Cancer Center and Research Institute, University of South Florida , Tampa , FL , USA
| | - Lisa Nodzon
- b Department of Malignant Hematology , H. Lee Moffitt Cancer Center and Research Institute , Tampa , FL , USA
| | - Mohamed A Kharfan-Dabaja
- e Department of Blood and Marrow Transplantation , H. Lee Moffitt Cancer Center and Research Institute , Tampa , FL , USA
| | - Javier Pinilla-Ibarz
- b Department of Malignant Hematology , H. Lee Moffitt Cancer Center and Research Institute , Tampa , FL , USA
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12
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The prognostic significance of 13q deletions of different sizes in patients with B-cell chronic lymphoproliferative disorders: a retrospective study. Int J Hematol 2017; 106:418-425. [PMID: 28439775 DOI: 10.1007/s12185-017-2240-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 04/09/2017] [Accepted: 04/12/2017] [Indexed: 01/12/2023]
Abstract
Patients with chronic lymphocytic leukemia (CLL) with 13q deletion as the sole cytogenetic abnormality usually have a favorable outcome, but the frequency of the 13q14 deletion and its impact on the outcome of other B-cell chronic lymphoproliferative disorders (BCLPDs) remain unclear. To further characterize this aberration, we investigated the prognostic significance of 13q deletion in 541 patients with BCLPDs. We performed fluorescence in situ hybridization (FISH) studies with 13q locus-specific LSI-D13S25 and LSI-RB1 probes. 52.1% of the patients with CLL harbored 13q deletion, which was significantly higher than that of other BCLPDs (p < 0.001). The size of 13q deletion was heterogeneous in both CLL and other BCLPDs. However, the distribution of cases with different deletion sizes showed no significant difference between the two groups. Whereas 13q deletion was a favorable prognostic factor in CLL, a large deletion of 13q was associated with poor prognosis in terms of time to first therapy (p = 0.020), progression-free survival (p = 0.05) and overall survival (p = 0.002) in BCLPD cases other than CLL. In conclusion, the deletion of 13q varied in size both in CLL and in other BCLPDs and adversely influenced the prognosis of patients with other BCLPDs.
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13
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Mátrai Z, Andrikovics H, Szilvási A, Bors A, Kozma A, Ádám E, Halm G, Karászi É, Tordai A, Masszi T. Lipoprotein Lipase as a Prognostic Marker in Chronic Lymphocytic Leukemia. Pathol Oncol Res 2016; 23:165-171. [PMID: 27757836 DOI: 10.1007/s12253-016-0132-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 10/12/2016] [Indexed: 12/29/2022]
Abstract
The marked clinical heterogeneity of CLL makes early prognosis assessment important. Lipoprotein lipase (LPL) has been shown to confer adverse prognosis in CLL, recent data indicating it might also contribute to CLL cell survival and metabolism. We determined LPL mRNA expression in unselected peripheral blood of 84 CLL patients by RT PCR. Results were correlated with other prognostic markers and outcome. 30/84 (40 %) of cases were LPL positive based on the cutoff established by ROC analysis. In LPL positive patients significantly shorter median survival (136 vs 258 months, p < 0.0001) and time to first treatment intervals (36 vs 144 months, p < 0.002) were documented. LPL values correlated with male gender, higher stages, more treatment requirement, CD38 positivity and unmutated IgVH genes. Among cases with 13q deletion, LPL positivity identified a subcohort with poor outcome (median survival 108 months vs NR, p < 0.0001). In multivariate analysis, cytogenetic aberrations and LPL had significant impact on survival. Our results confirm that LPL is a strong predictor of outcome in CLL, able to improve prognostic accuracy in good risk cytogenetic subgroups. The relationship between its prognostic and functional role in CLL needs to be explored further.
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Affiliation(s)
- Zoltán Mátrai
- Department of Haematology and Stem Cell Transplantation, St. István and St László Hospital, Budapest, Hungary.
| | - Hajnalka Andrikovics
- Laboratory of Molecular Diagnostics, Hungarian National Blood Transfusion Service, Budapest, Hungary
| | - Anikó Szilvási
- Laboratory of Molecular Diagnostics, Hungarian National Blood Transfusion Service, Budapest, Hungary
| | - András Bors
- Laboratory of Molecular Diagnostics, Hungarian National Blood Transfusion Service, Budapest, Hungary
| | - András Kozma
- Department of Haematology and Stem Cell Transplantation, St. István and St László Hospital, Budapest, Hungary
| | - Emma Ádám
- Department of Haematology and Stem Cell Transplantation, St. István and St László Hospital, Budapest, Hungary
| | - Gabriella Halm
- Department of Haematology and Stem Cell Transplantation, St. István and St László Hospital, Budapest, Hungary
| | - Éva Karászi
- Department of Haematology and Stem Cell Transplantation, St. István and St László Hospital, Budapest, Hungary
| | - Attila Tordai
- Laboratory of Molecular Diagnostics, Hungarian National Blood Transfusion Service, Budapest, Hungary
| | - Tamás Masszi
- Department of Haematology and Stem Cell Transplantation, St. István and St László Hospital, Budapest, Hungary.,Third Department of Internal Medicine, Semmelweis University, Budapest, Hungary
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14
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González-Gascón y Marín I, Martín AÁ, Hernández-Sanchez M, Robledo C, Hermosín ML, de las Heras N, Lacalle L, Galende J, de Arriba F, Rodríguez-Vicente AE, Hernández JÁ, Hernández-Rivas JM. Hyperdiploidy as a rare event that accompanies poor prognosis markers in CLL. Eur J Haematol 2016; 98:142-148. [DOI: 10.1111/ejh.12812] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2016] [Indexed: 12/27/2022]
Affiliation(s)
- Isabel González-Gascón y Marín
- Servicio de Hematología; Hospital Universitario Infanta Leonor; Madrid Spain
- Departamento de Medicina; Universidad Complutense; Madrid Spain
| | - Ana África Martín
- Servicio de Hematología; IBSAL-Hospital Universitario de Salamanca; Salamanca Spain
| | | | - Cristina Robledo
- Centro de Investigación del Cáncer-IBMCC; Universidad de Salamanca; Salamanca Spain
| | | | | | | | | | | | | | - José-Ángel Hernández
- Servicio de Hematología; Hospital Universitario Infanta Leonor; Madrid Spain
- Departamento de Medicina; Universidad Complutense; Madrid Spain
| | - Jesús María Hernández-Rivas
- Servicio de Hematología; IBSAL-Hospital Universitario de Salamanca; Salamanca Spain
- Centro de Investigación del Cáncer-IBMCC; Universidad de Salamanca; Salamanca Spain
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15
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Musto P, Negrini M, De Luca L, Cuneo A. Dissecting chronic lymphocytic leukemia with 13q- using microRNA expression profile. Leuk Res 2016; 47:114-5. [DOI: 10.1016/j.leukres.2016.05.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Accepted: 05/26/2016] [Indexed: 01/15/2023]
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16
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Hernández-Sánchez M, Rodríguez-Vicente AE, Hernández JÁ, Lumbreras E, Sarasquete ME, Martín AÁ, Benito R, Vicente-Gutiérrez C, Robledo C, Heras NDL, Rodríguez JN, Alcoceba M, Coca AGD, Aguilar C, González M, Hernández-Rivas JM. MiRNA expression profile of chronic lymphocytic leukemia patients with 13q deletion. Leuk Res 2016; 46:30-6. [DOI: 10.1016/j.leukres.2016.04.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 03/29/2016] [Accepted: 04/08/2016] [Indexed: 01/02/2023]
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17
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Amaya-Chanaga CI, Rassenti LZ. Biomarkers in chronic lymphocytic leukemia: Clinical applications and prognostic markers. Best Pract Res Clin Haematol 2016; 29:79-89. [DOI: 10.1016/j.beha.2016.08.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 07/07/2016] [Accepted: 08/04/2016] [Indexed: 02/01/2023]
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18
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Mosaic 13q14 deletions in peripheral leukocytes of non-hematologic cancer cases and healthy controls. J Hum Genet 2016; 61:411-8. [PMID: 26763882 PMCID: PMC4880507 DOI: 10.1038/jhg.2015.166] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 12/07/2015] [Accepted: 12/10/2015] [Indexed: 01/07/2023]
Abstract
Loss of 13q14.3 is a chromosomal event found in approximately 50 percent of B-cell chronic lymphocytic leukemia (CLL) and monoclonal B-cell lymphocytosis (MBL) cases. Surveys of somatic alterations in solid tumors have shown sporadic 13q14.3 loss in many different tumor types, but not at high frequency in any specific tumor type. In our recent survey of the single nucleotide polymorphism (SNP) microarray data from 127,000 cancer free or solid tumor cases, we observed mosaic 13q14.3 loss as a common autosomal somatic large structural events (>2 Mb in size) in blood and buccal-derived DNA. Herein, we examined this region more closely investigating structural mosaic events <2 Mb using SNP microarray data in 46,254 non-hematologic cancer cases and 36,229 controls. We detected 60 individuals with 13q14.3 mosaic loss, one mosaic copy neutral uniparental disomy, and 13 individuals with homozygosity. While 13q14.3 loss size was variable, the minimally deleted region (MDR) (chr13:49,590,000-49,983,100; GRCh36) was comparable to what is classically reported in MBL and CLL. Breakpoint analysis of the estimated boundaries reveals enrichment for genes and open chromatin. The frequency of 13q14.3 loss significantly increases with increasing age (P-value=0.028), but was not significantly different between non-hematological cancer cases and controls (0.084% versus 0.058%; P-value=0.19). These findings suggest mosaic 13q14.3 losses accumulate with age. Individuals with detected mosaic 13q14.3 deletions may be early, undetected cases of MBL or CLL, but not necessarily all will develop MBL and CLL.
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19
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Hernández JÁ, Hernández-Sánchez M, Rodríguez-Vicente AE, Grossmann V, Collado R, Heras C, Puiggros A, Martín AÁ, Puig N, Benito R, Robledo C, Delgado J, González T, Queizán JA, Galende J, de la Fuente I, Martín-Núñez G, Alonso JM, Abrisqueta P, Luño E, Marugán I, González-Gascón I, Bosch F, Kohlmann A, González M, Espinet B, Hernández-Rivas JM. A Low Frequency of Losses in 11q Chromosome Is Associated with Better Outcome and Lower Rate of Genomic Mutations in Patients with Chronic Lymphocytic Leukemia. PLoS One 2015; 10:e0143073. [PMID: 26630574 PMCID: PMC4667902 DOI: 10.1371/journal.pone.0143073] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 10/30/2015] [Indexed: 12/11/2022] Open
Abstract
To analyze the impact of the 11q deleted (11q-) cells in CLL patients on the time to first therapy (TFT) and overall survival (OS), 2,493 patients with CLL were studied. 242 patients (9.7%) had 11q-. Fluorescence in situ hybridization (FISH) studies showed a threshold of 40% of deleted cells to be optimal for showing that clinical differences in terms of TFT and OS within 11q- CLLs. In patients with ≥40% of losses in 11q (11q-H) (74%), the median TFT was 19 months compared with 44 months in CLL patients with <40% del(11q) (11q-L) (P<0.0001). In the multivariate analysis, only the presence of 11q-L, mutated IGHV status, early Binet stage and absence of extended lymphadenopathy were associated with longer TFT. Patients with 11q-H had an OS of 90 months, while in the 11q-L group the OS was not reached (P = 0.008). The absence of splenomegaly (P = 0.02), low LDH (P = 0.018) or β2M (P = 0.006), and the presence of 11q-L (P = 0.003) were associated with a longer OS. In addition, to detect the presence of mutations in the ATM, TP53, NOTCH1, SF3B1, MYD88, FBXW7, XPO1 and BIRC3 genes, a select cohort of CLL patients with losses in 11q was sequenced by next-generation sequencing of amplicons. Eighty % of CLLs with 11q- showed mutations and fewer patients with low frequencies of 11q- had mutations among genes examined (50% vs 94.1%, P = 0.023). In summary, CLL patients with <40% of 11q- had a long TFT and OS that could be associated with the presence of fewer mutated genes.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Chromosome Deletion
- Chromosomes, Human, Pair 11
- Female
- Gene Expression
- High-Throughput Nucleotide Sequencing
- Humans
- Immunoglobulin Heavy Chains/genetics
- In Situ Hybridization, Fluorescence
- Karyotype
- Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/mortality
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Male
- Middle Aged
- Mutation
- Neoplasm Proteins/genetics
- Neoplasm Proteins/immunology
- Prognosis
- Retrospective Studies
- Survival Analysis
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Affiliation(s)
- José Ángel Hernández
- Hematology Department, Hospital Universitario Infanta Leonor, Universidad Complutense de Madrid, Madrid, Spain
| | - María Hernández-Sánchez
- IBSAL, IBMCC, Centro de Investigación del Cáncer, Universidad de Salamanca,CSIC, Hospital Universitario de Salamanca, Spain
| | - Ana Eugenia Rodríguez-Vicente
- IBSAL, IBMCC, Centro de Investigación del Cáncer, Universidad de Salamanca,CSIC, Hospital Universitario de Salamanca, Spain
| | | | - Rosa Collado
- Hematology Department, Hospital General, Valencia, Spain
| | - Cecilia Heras
- Hematology Department, Hospital Universitario Infanta Leonor, Universidad Complutense de Madrid, Madrid, Spain
| | - Anna Puiggros
- Pathology Department, Hospital del Mar, Barcelona, Spain
| | | | - Noemí Puig
- Hematology Department, Hospital Universitario, Salamanca, Spain
| | - Rocío Benito
- IBSAL, IBMCC, Centro de Investigación del Cáncer, Universidad de Salamanca,CSIC, Hospital Universitario de Salamanca, Spain
| | - Cristina Robledo
- IBSAL, IBMCC, Centro de Investigación del Cáncer, Universidad de Salamanca,CSIC, Hospital Universitario de Salamanca, Spain
| | - Julio Delgado
- Hematology Department, Hospital Clinic i Provincial, Barcelona, Spain
| | - Teresa González
- Fundación Pública Galega de Medicina Xenómica, Santiago de Compostela, Spain
| | | | - Josefina Galende
- Hematology Department, Hospital del Bierzo, Ponferrada, León, Spain
| | | | | | | | - Pau Abrisqueta
- Hematology Department, Hospital Vall d'Hebron, Barcelona, Spain
| | - Elisa Luño
- Hematology Department, Hospital Central de Asturias, Oviedo, Spain
| | - Isabel Marugán
- Hematology Department, Hospital Clínico, Valencia, Spain
| | - Isabel González-Gascón
- Hematology Department, Hospital Universitario Infanta Leonor, Universidad Complutense de Madrid, Madrid, Spain
| | - Francesc Bosch
- Hematology Department, Hospital Vall d'Hebron, Barcelona, Spain
| | - Alexander Kohlmann
- MLL Munich, Germany
- AstraZeneca, Personalized Healthcare and Biomarkers, Innovative Medicines, Macclesfield, United Kingdom
| | - Marcos González
- IBSAL, IBMCC, Centro de Investigación del Cáncer, Universidad de Salamanca,CSIC, Hospital Universitario de Salamanca, Spain
- Hematology Department, Hospital Universitario, Salamanca, Spain
| | - Blanca Espinet
- Pathology Department, Hospital del Mar, Barcelona, Spain
| | - Jesús María Hernández-Rivas
- IBSAL, IBMCC, Centro de Investigación del Cáncer, Universidad de Salamanca,CSIC, Hospital Universitario de Salamanca, Spain
- Hematology Department, Hospital Universitario, Salamanca, Spain
- Department of Medicine, Universidad de Salamanca, Spain
- * E-mail:
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20
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Huang SJT, Gillan TL, Gerrie AS, Hrynchak M, Karsan A, Ramadan K, Smith AC, Toze CL, Bruyere H. Influence of clone and deletion size on outcome in chronic lymphocytic leukemia patients with an isolated deletion 13q in a population-based analysis in British Columbia, Canada. Genes Chromosomes Cancer 2015; 55:16-24. [PMID: 26391112 DOI: 10.1002/gcc.22294] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 08/05/2015] [Indexed: 01/22/2023] Open
Abstract
Deletion of the long arm of chromosome 13 (del(13q)) as the sole abnormality in chronic lymphocytic leukemia (CLL) portends a good prognosis; however, there is great outcome heterogeneity within this subgroup. The percentage of cells with a del(13q) (clone size) and the extent of the deletion are two factors that may affect outcome in CLL patients with isolated del(13q). We analyzed 248 CLL patients from the BC Provincial CLL database identified as having isolated del(13q) detected pretreatment by interphase fluorescence in situ hybridization to determine what impact clone and deletion size had on overall survival (OS) and treatment free survival (TFS). Patients with 60% or more of nuclei with a del(13q) had shorter TFS and shorter OS. A large deletion, encompassing the RB1 gene locus, was detected in half of the 90 cases with available specimens for testing, and there was no significant difference in OS and TFS between RB1-deleted and RB1-not-deleted cases. Further study in a larger sample size is required to determine the clinical interest of RB1 locus testing; however, clone size of del(13q) does predict TFS and OS and may better refine prognosis in this clinically heterogeneous population.
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Affiliation(s)
- Steven J T Huang
- Leukemia/BMT Program of BC, Vancouver General Hospital and British Columbia Cancer Agency, University of British Columbia, Vancouver, BC, Canada.,Pathology and Laboratory Medicine, Vancouver General Hospital University of British Columbia, Vancouver, BC, Canada
| | - Tanya L Gillan
- Pathology and Laboratory Medicine, Vancouver General Hospital University of British Columbia, Vancouver, BC, Canada
| | - Alina S Gerrie
- Leukemia/BMT Program of BC, Vancouver General Hospital and British Columbia Cancer Agency, University of British Columbia, Vancouver, BC, Canada
| | - Monica Hrynchak
- Department of Laboratory Medicine Molecular Cytogenetic Laboratory, Royal Columbian Hospital, University of British Columbia, New Westminster, BC, Canada
| | - Aly Karsan
- Pathology and Laboratory Medicine, British Columbia Cancer Agency, Vancouver, BC, Canada
| | - Khaled Ramadan
- Division of Hematology, St. Paul's Hospital University of British Columbia, Vancouver, BC, Canada
| | - Adam C Smith
- Instituto De Pesquisa Pelé Pequeno Príncipe, Curitiba, Brazil and the Dept. Of Pathology, University of British Columbia, Vancouver, Canada
| | - Cynthia L Toze
- Leukemia/BMT Program of BC, Vancouver General Hospital and British Columbia Cancer Agency, University of British Columbia, Vancouver, BC, Canada
| | - Helene Bruyere
- Pathology and Laboratory Medicine, Vancouver General Hospital University of British Columbia, Vancouver, BC, Canada
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21
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Davids MS, Vartanov A, Werner L, Neuberg D, Dal Cin P, Brown JR. Controversial fluorescencein situhybridization cytogenetic abnormalities in chronic lymphocytic leukaemia: new insights from a large cohort. Br J Haematol 2015; 170:694-703. [DOI: 10.1111/bjh.13498] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 03/24/2015] [Indexed: 01/20/2023]
Affiliation(s)
- Matthew S. Davids
- Department of Medical Oncology; Dana-Farber Cancer Institute; Harvard Medical School; Boston MA USA
| | - Alexander Vartanov
- Department of Medical Oncology; Dana-Farber Cancer Institute; Harvard Medical School; Boston MA USA
| | - Lillian Werner
- Biostatistics and Computational Biology; Dana-Farber Cancer Institute; Boston MA USA
| | - Donna Neuberg
- Biostatistics and Computational Biology; Dana-Farber Cancer Institute; Boston MA USA
| | - Paola Dal Cin
- Department of Pathology; Brigham & Women's Hospital; Boston MA USA
| | - Jennifer R. Brown
- Department of Medical Oncology; Dana-Farber Cancer Institute; Harvard Medical School; Boston MA USA
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22
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González-Gascón y Marín I, Hernández-Sánchez M, Rodríguez-Vicente AE, Sanzo C, Aventín A, Puiggros A, Collado R, Heras C, Muñoz C, Delgado J, Ortega M, González MT, Marugán I, de la Fuente I, Recio I, Bosch F, Espinet B, González M, Hernández-Rivas JM, Hernández JÁ. A high proportion of cells carrying trisomy 12 is associated with a worse outcome in patients with chronic lymphocytic leukemia. Hematol Oncol 2015; 34:84-92. [DOI: 10.1002/hon.2196] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2014] [Revised: 01/19/2015] [Accepted: 01/21/2015] [Indexed: 11/10/2022]
Affiliation(s)
| | - María Hernández-Sánchez
- Servicio de Hematología; IBSAL-Hospital Universitario de Salamanca; Spain
- Centro de Investigación del Cáncer-IBMCC, Universidad de Salamanca (USAL-CSIC); Spain
| | - Ana-Eugenia Rodríguez-Vicente
- Servicio de Hematología; IBSAL-Hospital Universitario de Salamanca; Spain
- Centro de Investigación del Cáncer-IBMCC, Universidad de Salamanca (USAL-CSIC); Spain
| | | | | | | | | | - Cecilia Heras
- Servicio de Hematología; Hospital Universitario Infanta Leonor; Madrid Spain
| | - Carolina Muñoz
- Servicio de Hematología; Hospital Universitario Infanta Leonor; Madrid Spain
| | | | | | | | | | | | - Isabel Recio
- Hospital Nuestra Señora de Sonsoles; Avila Spain
| | | | | | - Marcos González
- Servicio de Hematología; IBSAL-Hospital Universitario de Salamanca; Spain
- Centro de Investigación del Cáncer-IBMCC, Universidad de Salamanca (USAL-CSIC); Spain
| | - Jesús-María Hernández-Rivas
- Servicio de Hematología; IBSAL-Hospital Universitario de Salamanca; Spain
- Centro de Investigación del Cáncer-IBMCC, Universidad de Salamanca (USAL-CSIC); Spain
| | - José-Ángel Hernández
- Servicio de Hematología; Hospital Universitario Infanta Leonor; Madrid Spain
- Universidad Complutense; Madrid Spain
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23
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Shahjahani M, Mohammadiasl J, Noroozi F, Seghatoleslami M, Shahrabi S, Saba F, Saki N. Molecular basis of chronic lymphocytic leukemia diagnosis and prognosis. Cell Oncol (Dordr) 2015; 38:93-109. [PMID: 25563586 DOI: 10.1007/s13402-014-0215-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/23/2014] [Indexed: 12/31/2022] Open
Abstract
BACKGROUNDS Chronic lymphocytic leukemia (CLL) is the most common type of leukemia in adults and is characterized by a clonal accumulation of mature apoptosis-resistant neoplastic cells. It is also a heterogeneous disease with a variable clinical outcome. Here, we present a review of currently known (epi)genetic alterations that are related to the etiology, progression and chemo-refractoriness of CLL. Relevant literature was identified through a PubMed search (1994-2014) of English-language papers using the terms CLL, signaling pathway, cytogenetic abnormality, somatic mutation, epigenetic alteration and micro-RNA. RESULTS CLL is characterized by the presence of gross chromosomal abnormalities, epigenetic alterations, micro-RNA expression alterations, immunoglobulin heavy chain gene mutations and other genetic lesions. The expression of unmutated immunoglobulin heavy chain variable region (IGHV) genes, ZAP-70 and CD38 proteins, the occurrence of chromosomal abnormalities such as 17p and 11q deletions and mutations of the NOTCH1, SF3B1 and BIRC3 genes have been associated with a poor prognosis. In addition, mutations in tumor suppressor genes, such as TP53 and ATM, have been associated with refractoriness to conventional chemotherapeutic agents. Micro-RNA expression alterations and aberrant methylation patterns in genes that are specifically deregulated in CLL, including the BCL-2, TCL1 and ZAP-70 genes, have also been encountered and linked to distinct clinical parameters. CONCLUSIONS Specific chromosomal abnormalities and gene mutations may serve as diagnostic and prognostic indicators for disease progression and survival. The identification of these anomalies by state-of-the-art molecular (cyto)genetic techniques such as fluorescence in situ hybridization (FISH), comparative genomic hybridization (CGH), single nucleotide polymorphism (SNP) microarray-based genomic profiling and next-generation sequencing (NGS) can be of paramount help for the clinical management of these patients, including optimal treatment design. The efficacy of novel therapeutics should to be tested according to the presence of these molecular lesions in CLL patients.
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Affiliation(s)
- Mohammad Shahjahani
- Department of Hematology and Blood Banking, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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24
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Puiggros A, Venturas M, Salido M, Blanco G, Fernandez-Rodriguez C, Collado R, Valiente A, Ruiz-Xivillé N, Carrió A, Ortuño FJ, Luño E, Calasanz MJ, Ardanaz MT, Piñán MÁ, Talavera E, González MT, Ortega M, Marugán I, Ferrer A, Gimeno E, Bellosillo B, Delgado J, Hernández JÁ, Hernández-Rivas JM, Espinet B. Interstitial 13q14 deletions detected in the karyotype and translocations with concomitant deletion at 13q14 in chronic lymphocytic leukemia: different genetic mechanisms but equivalent poorer clinical outcome. Genes Chromosomes Cancer 2014; 53:788-97. [PMID: 24915757 DOI: 10.1002/gcc.22188] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Revised: 05/22/2014] [Accepted: 05/23/2014] [Indexed: 01/21/2023] Open
Abstract
Deletion of 13q14 as the sole abnormality is a good prognostic marker in chronic lymphocytic leukemia (CLL). Nonetheless, the prognostic value of reciprocal 13q14 translocations [t(13q)] with related 13q losses has not been fully elucidated. We described clinical and biological characteristics of 25 CLL patients with t(13q), and compared with 62 patients carrying interstitial del(13q) by conventional G-banding cytogenetics (CGC) [i-del(13q)] and 295 patients with del(13q) only detected by fluorescence in situ hybridization (FISH) [F-del(13q)]. Besides from the CLL FISH panel (D13S319, CEP12, ATM, TP53), we studied RB1 deletions in all t(13q) cases and a representative group of i-del(13q) and F-del(13q). We analyzed NOTCH1, SF3B1, and MYD88 mutations in t(13q) cases by Sanger sequencing. In all, 25 distinct t(13q) were described. All these cases showed D13S319 deletion while 32% also lost RB1. The median percentage of 13q-deleted nuclei did not differ from i-del(13q) patients (73% vs. 64%), but both were significantly higher than F-del(13q) (52%, P < 0.001). Moreover, t(13q) patients showed an increased incidence of biallelic del(13q) (52% vs. 11.3% and 14.9%, P < 0.001) and higher rates of concomitant 17p deletion (37.5% vs. 8.6% and 7.2%, P < 0.001). RB1 involvement was significantly higher in the i-del(13q) group (79%, P < 0.001). Two t(13q) patients (11.8%) carried NOTCH1 mutations. Time to first treatment in t(13q) and i-del(13q) was shorter than F-del(13q) (67, 44, and 137 months, P = 0.029), and preserved significance in the multivariate analysis. In conclusion, t(13q) and del(13q) patients detected by CGC constitute a subgroup within the 13q-deleted CLL patients associated with a worse clinical outcome.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Chromosome Aberrations
- Chromosome Deletion
- Chromosomes, Human, Pair 13/genetics
- Cohort Studies
- Female
- Humans
- Karyotype
- Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Male
- Middle Aged
- Myeloid Differentiation Factor 88/genetics
- Phosphoproteins/genetics
- Prognosis
- RNA Splicing Factors
- Receptor, Notch1/genetics
- Retinoblastoma Protein/genetics
- Ribonucleoprotein, U2 Small Nuclear/genetics
- Translocation, Genetic
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Affiliation(s)
- Anna Puiggros
- Laboratori de Citogenètica Molecular, Laboratori de Citologia Hematològica, Servei de Patologia, Hospital del Mar, Barcelona, Spain; Grup de Recerca Translacional en Neoplàsies Hematològiques, Cancer Res Program, IMIM-Hospital del Mar, Barcelona, Spain
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25
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Genetic abnormalities in chronic lymphocytic leukemia: where we are and where we go. BIOMED RESEARCH INTERNATIONAL 2014; 2014:435983. [PMID: 24967369 PMCID: PMC4054680 DOI: 10.1155/2014/435983] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Accepted: 04/22/2014] [Indexed: 12/17/2022]
Abstract
Chromosomal abnormalities in chronic lymphocytic leukemia (CLL) are detected in up to 80% of patients. Among them, deletions of 11q, 13q, 17p, and trisomy 12 have a known prognostic value and play an important role in CLL pathogenesis and evolution, determining patients outcome and therapeutic strategies. Standard methods used to identify these genomic aberrations include both conventional G-banding cytogenetics (CGC) and fluorescence in situ hybridization (FISH). Although FISH analyses have been implemented as the gold standard, CGC allows the identification of chromosomal translocations and complex karyotypes, the latest associated with poor outcome. Genomic arrays have a higher resolution that allows the detection of cryptic abnormalities, although these have not been fully implemented in routine laboratories. In the last years, next generation sequencing (NGS) methods have identified a wide range of gene mutations (e.g., TP53, NOTCH1, SF3B1, and BIRC3) which have improved our knowledge about CLL development, allowing us to refine both the prognostic subgroups and better therapeutic strategies. Clonal evolution has also recently arisen as a key point in CLL, integrating cytogenetic alterations and mutations in a dynamic model that improve our understanding about its clinical course and relapse.
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26
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González-Gascón y Marín I, Hernández JA, Martín A, Alcoceba M, Sarasquete ME, Rodríguez-Vicente A, Heras C, de las Heras N, Fisac R, García de Coca A, de la Fuente I, Hernández-Sánchez M, Recio I, Galende J, Martín-Núñez G, Alonso JM, Hernández-Rivas JM, González M. Mutation status and immunoglobulin gene rearrangements in patients from northwest and central region of Spain with chronic lymphocytic leukemia. BIOMED RESEARCH INTERNATIONAL 2014; 2014:257517. [PMID: 24790994 PMCID: PMC3985179 DOI: 10.1155/2014/257517] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Revised: 02/07/2014] [Accepted: 02/24/2014] [Indexed: 01/09/2023]
Abstract
The aim of this study was to investigate the frequency and mutation status of the immunoglobulin heavy variable chain (IGHV) in a cohort of 224 patients from northwest and central region of Spain diagnosed with chronic lymphocytic leukemia (CLL), and to correlate it with cytogenetic abnormalities, overall survival (OS) and time to first treatment (TTFT). 125 patients had mutated IGHV, while 99 had unmutated IGHV. The most frequently used IGHV family was IGHV3, followed by IGHV1 and IGHV4. The regions IGHV3-30, IGHV1-69, IGHV3-23, and IGHV4-34 were the most commonly used. Only 3.1% of the patients belonged to the subfamily IGHV3-21 and we failed to demonstrate a worse clinical outcome in this subgroup. The IGHV4 family appeared more frequently with mutated pattern, similar to IGHV3-23 and IGHV3-74. By contrast, IGHV1-69 was expressed at a higher frequency in unmutated CLL patients. All the cases from IGHV3-11 and almost all from IGHV5-51 subfamily belonged to the group of unmutated CLL.
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Affiliation(s)
- I. González-Gascón y Marín
- Servicio de Hematología, Departamento de Medicina, Hospital Universitario Infanta Leonor, Calle Gran Vía del Este 80, 28031 Madrid, Spain
| | - J. A. Hernández
- Servicio de Hematología, Departamento de Medicina, Hospital Universitario Infanta Leonor, Calle Gran Vía del Este 80, 28031 Madrid, Spain
- Universidad Complutense de Madrid, Avenida Séneca 2, 28040 Madrid, Spain
| | - A. Martín
- Servicio de Hematología, IBSAL-Hospital Universitario de Salamanca, Paseo de San Vicente 58-182, 37007 Salamanca, Spain
| | - M. Alcoceba
- Servicio de Hematología, IBSAL-Hospital Universitario de Salamanca, Paseo de San Vicente 58-182, 37007 Salamanca, Spain
| | - M. E. Sarasquete
- Servicio de Hematología, IBSAL-Hospital Universitario de Salamanca, Paseo de San Vicente 58-182, 37007 Salamanca, Spain
| | - A. Rodríguez-Vicente
- Centro de Investigación del Cáncer-IBMCC, Universidad de Salamanca (USAL-CSIC), Calle Zacarías González 2, 37007 Salamanca, Spain
| | - C. Heras
- Servicio de Hematología, Departamento de Medicina, Hospital Universitario Infanta Leonor, Calle Gran Vía del Este 80, 28031 Madrid, Spain
| | - N. de las Heras
- Servicio de Hematología, Hospital Virgen Blanca, Calle Altos de Nava, s/n, 24071 León, Spain
| | - R. Fisac
- Servicio de Hematología, Hospital General de Segovia, Calle Miguel Servet, s/n, 4002 Segovia, Spain
| | - A. García de Coca
- Servicio de Hematología, Hospital Clínico Universitario de Valladolid, Avenida Ramón y Cajal 3, 47005 Valladolid, Spain
| | - I. de la Fuente
- Servicio de Hematología, Hospital del Río Hortega, Calle Dulzaina 2, 47012 Valladolid, Spain
| | - M. Hernández-Sánchez
- Centro de Investigación del Cáncer-IBMCC, Universidad de Salamanca (USAL-CSIC), Calle Zacarías González 2, 37007 Salamanca, Spain
| | - I. Recio
- Servicio de Hematología, Hospital Nuestra Señora de Sonsoles, Plaza de Santiago 1, 05002 Ávila, Spain
| | - J. Galende
- Servicio de Hematología, Hospital El Bierzo, Calle Médicos sin Fronteras 7, 24411 Ponferrada, León, Spain
| | - G. Martín-Núñez
- Servicio de Hematología, Hospital Virgen del Puerto, Paraje Valcorchero, 10600 Plasencia, Cáceres, Spain
| | - J. M. Alonso
- Servicio de Hematología, Hospital Río Carrión, Avenida Donantes de Sangre, s/n, 34005 Palencia, Spain
| | - J. M. Hernández-Rivas
- Servicio de Hematología, IBSAL-Hospital Universitario de Salamanca, Paseo de San Vicente 58-182, 37007 Salamanca, Spain
- Centro de Investigación del Cáncer-IBMCC, Universidad de Salamanca (USAL-CSIC), Calle Zacarías González 2, 37007 Salamanca, Spain
| | - M. González
- Servicio de Hematología, IBSAL-Hospital Universitario de Salamanca, Paseo de San Vicente 58-182, 37007 Salamanca, Spain
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27
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TET2 overexpression in chronic lymphocytic leukemia is unrelated to the presence of TET2 variations. BIOMED RESEARCH INTERNATIONAL 2014; 2014:814294. [PMID: 24693539 PMCID: PMC3947698 DOI: 10.1155/2014/814294] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Accepted: 01/07/2014] [Indexed: 12/11/2022]
Abstract
TET2 is involved in a variety of hematopoietic malignancies, mainly in myeloid malignancies. Most mutations of TET2 have been identified in myeloid disorders, but some have also recently been described in mature lymphoid neoplasms. In contrast to the large amount of data about mutations of TET2, some data are available for gene expression. Moreover, the role of TET2 in chronic lymphocytic leukemia (CLL) is unknown. This study analyzes both TET2 expression and mutations in 48 CLL patients. TET2 expression was analyzed by exon arrays and quantitative real-time polymerase chain reaction (qRT-PCR). Next-generation sequencing (NGS) technology was applied to investigate the presence of TET2 variations. Overexpression of TET2 was observed in B-cell lymphocytes from CLL patients compared with healthy donors (P = 0.004). In addition, in CLL patients, an overexpression of TET2 was also observed in the clonal B cells compared with the nontumoral cells (P = 0.002). However, no novel mutations were observed. Therefore, overexpression of TET2 in CLL seems to be unrelated to the presence of genomic TET2 variations.
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28
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Puiggros A, Delgado J, Rodriguez-Vicente A, Collado R, Aventín A, Luño E, Grau J, Hernandez JÁ, Marugán I, Ardanaz M, González T, Valiente A, Osma M, Calasanz MJ, Sanzo C, Carrió A, Ortega M, Santacruz R, Abrisqueta P, Abella E, Bosch F, Carbonell F, Solé F, Hernández JM, Espinet B. Biallelic losses of 13q do not confer a poorer outcome in chronic lymphocytic leukaemia: analysis of 627 patients with isolated 13q deletion. Br J Haematol 2013; 163:47-54. [PMID: 23869550 DOI: 10.1111/bjh.12479] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Accepted: 06/12/2013] [Indexed: 12/30/2022]
Abstract
Losses in 13q as a sole abnormality confer a good prognosis in chronic lymphocytic leukaemia (CLL). Nevertheless, its heterogeneity has been demonstrated and the clinical significance of biallelic 13q deletions remains controversial. We compared the clinico-biological characteristics of a series of 627 patients harbouring isolated 13q deletions by fluorescence in situ hybridization (FISH), either monoallelic (13q × 1), biallelic (13q × 2), or the coexistence of both clones (13qM). The most frequent 13q deletion was 13q × 1 (82·1%), while 13q × 2 and 13qM represented 8·6% and 9·3% of patients respectively. The median percentage of altered nuclei significantly differed across groups: 55%, 72·5% and 80% in 13q × 1, 13q × 2 and 13qM (P < 0·001). However, no significant differences in the clinical outcome among 13q groups were found. From 84 patients with sequential FISH studies, eight patients lost the remaining allele of 13q whereas none of them changed from 13q × 2 to the 13q × 1 group. The percentage of abnormal cells detected by FISH had a significant impact on the five-year cumulative incidence of treatment and the overall survival, 90% being the highest predictive power cut-off. In conclusion, loss of the remaining 13q allele is not enough to entail a worse prognosis in CLL. The presence of isolated 13q deletion can be risk-stratified according to the percentage of altered cells.
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Affiliation(s)
- Anna Puiggros
- Laboratori de Citogenètica Molecular, Laboratori de Citologia Hematològica, Servei de Patologia, Hospital del Mar, Barcelona, Spain; Grup de Recerca Translacional en Neoplàsies Hematològiques, Cancer Research Program, IMIM-Hospital del Mar., Barcelona, Spain
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29
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Rodríguez-Vicente AE, Díaz MG, Hernández-Rivas JM. Chronic lymphocytic leukemia: a clinical and molecular heterogenous disease. Cancer Genet 2013; 206:49-62. [DOI: 10.1016/j.cancergen.2013.01.003] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Revised: 01/21/2013] [Accepted: 01/24/2013] [Indexed: 12/11/2022]
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30
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Rodríguez AE, Hernández JÁ, Benito R, Gutiérrez NC, García JL, Hernández-Sánchez M, Risueño A, Sarasquete ME, Fermiñán E, Fisac R, de Coca AG, Martín-Núñez G, de las Heras N, Recio I, Gutiérrez O, De Las Rivas J, González M, Hernández-Rivas JM. Molecular characterization of chronic lymphocytic leukemia patients with a high number of losses in 13q14. PLoS One 2012; 7:e48485. [PMID: 23152777 PMCID: PMC3496725 DOI: 10.1371/journal.pone.0048485] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Accepted: 10/02/2012] [Indexed: 12/22/2022] Open
Abstract
Background Patients with chronic lymphocytic leukemia and 13q deletion as their only FISH abnormality could have a different outcome depending on the number of cells displaying this aberration. Thus, cases with a high number of 13q- cells (13q-H) had both shorter overall survival and time to first therapy. The goal of the study was to analyze the genetic profile of 13q-H patients. Design and Methods: A total of 102 samples were studied, 32 of which served as a validation cohort and five were healthy donors. Results Chronic lymphocytic leukemia patients with higher percentages of 13q- cells (>80%) showed a different level of gene expression as compared to patients with lower percentages (<80%, 13q-L). This deregulation affected genes involved in apoptosis and proliferation (BCR and NFkB signaling), leading to increased proliferation and decreased apoptosis in 13q-H patients. Deregulation of several microRNAs, such as miR-15a, miR-155, miR-29a and miR-223, was also observed in these patients. In addition, our study also suggests that the gene expression pattern of 13q-H cases could be similar to the patients with 11q- or 17p-. Conclusions This study provides new evidence regarding the heterogeneity of 13q deletion in chronic lymphocytic leukemia patients, showing that apoptosis, proliferation as well as miRNA regulation are involved in cases with higher percentages of 13q- cells.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Alleles
- Case-Control Studies
- Chromosome Deletion
- Chromosomes, Human, Pair 11
- Chromosomes, Human, Pair 13
- Chromosomes, Human, Pair 17
- Cluster Analysis
- Female
- Gene Expression Profiling
- Gene Expression Regulation, Leukemic
- Humans
- Immunoglobulin Heavy Chains/genetics
- Immunoglobulin Variable Region/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/metabolism
- Male
- MicroRNAs/genetics
- MicroRNAs/metabolism
- Middle Aged
- Mutation
- Signal Transduction
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Affiliation(s)
- Ana Eugenia Rodríguez
- IBSAL,IBMCC, Centro de Investigación del Cáncer, Universidad de Salamanca-CSIC, Salamanca, Spain
| | | | - Rocío Benito
- IBSAL,IBMCC, Centro de Investigación del Cáncer, Universidad de Salamanca-CSIC, Salamanca, Spain
| | - Norma C. Gutiérrez
- Servicio de Hematología, Hospital Clínico Universitario de Salamanca, Salamanca, Spain
| | - Juan Luis García
- Instituto de Estudios de Ciencias de la Salud de Castilla y León, (IECSCYL)–HUSAL, Castilla y León, Spain
| | - María Hernández-Sánchez
- IBSAL,IBMCC, Centro de Investigación del Cáncer, Universidad de Salamanca-CSIC, Salamanca, Spain
| | - Alberto Risueño
- Grupo de Bioinformática y Genómica Funcional, IBMCC, Centro de Investigación del Cáncer, Universidad de Salamanca-CSIC, Salamanca, Spain
- Celgene Institute for Translational Research Europe (CITRE), Sevilla, Spain
| | - M. Eugenia Sarasquete
- Servicio de Hematología, Hospital Clínico Universitario de Salamanca, Salamanca, Spain
| | - Encarna Fermiñán
- Unidad de Genómica, IBMCC, Centro de Investigación del Cáncer, Universidad de Salamanca-CSIC, Salamanca, Spain
| | - Rosa Fisac
- Servicio de Hematología, Hospital General de Segovia, Segovia, Spain
| | | | | | | | - Isabel Recio
- Servicio de Hematología, Hospital Nuestra Señora de Sonsoles, Ávila, Spain
| | - Oliver Gutiérrez
- Servicio de Hematología, Hospital del Río Hortega, Valladolid, Spain
| | - Javier De Las Rivas
- Grupo de Bioinformática y Genómica Funcional, IBMCC, Centro de Investigación del Cáncer, Universidad de Salamanca-CSIC, Salamanca, Spain
| | - Marcos González
- IBSAL,IBMCC, Centro de Investigación del Cáncer, Universidad de Salamanca-CSIC, Salamanca, Spain
- Servicio de Hematología, Hospital Clínico Universitario de Salamanca, Salamanca, Spain
| | - Jesús M. Hernández-Rivas
- IBSAL,IBMCC, Centro de Investigación del Cáncer, Universidad de Salamanca-CSIC, Salamanca, Spain
- Servicio de Hematología, Hospital Clínico Universitario de Salamanca, Salamanca, Spain
- * E-mail:
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Fontanillo C, Aibar S, Sanchez-Santos JM, De Las Rivas J. Combined analysis of genome-wide expression and copy number profiles to identify key altered genomic regions in cancer. BMC Genomics 2012; 13 Suppl 5:S5. [PMID: 23095915 PMCID: PMC3476997 DOI: 10.1186/1471-2164-13-s5-s5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Analysis of DNA copy number alterations and gene expression changes in human samples have been used to find potential target genes in complex diseases. Recent studies have combined these two types of data using different strategies, but focusing on finding gene-based relationships. However, it has been proposed that these data can be used to identify key genomic regions, which may enclose causal genes under the assumption that disease-associated gene expression changes are caused by genomic alterations.
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Affiliation(s)
- Celia Fontanillo
- Cancer Research Center, Consejo Superior de Investigaciones Cientificas, Campus Miguel de Unamuno, Salamanca, Spain.
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Orlandi EM, Bernasconi P, Pascutto C, Giardini I, Cavigliano PM, Boni M, Zibellini S, Cazzola M. Chronic lymphocytic leukemia with del13q14 as the sole abnormality: dynamic prognostic estimate by interphase-FISH. Hematol Oncol 2012; 31:136-42. [PMID: 23060227 DOI: 10.1002/hon.2032] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2012] [Revised: 09/13/2012] [Accepted: 09/14/2012] [Indexed: 02/05/2023]
Abstract
This study analyzed 140 patients with isolated del13q14 on interphase FISH (I-FISH), to identify subsets with a different progression risk and to assess the acquisition of additional chromosomal abnormalities (clonal evolution) in treatment-naïve del13q14 patients. A monoallelic deletion (del13qx1) was detected in 123 cases (88%), a biallelic deletion (del13qx2) in eight and a mosaic of monoallelic and biallelic deletions (del13qx1/del13qx2) in nine. In 33% of cases, deletion encompassed the Rb1 locus The median percentage of abnormal nuclei was 50% (15%-96%), and it was higher in patients with a biallelic/mosaic pattern in comparison with patients with monoallelic deletion. Sixty two patients (44%) have been treated; 5-year treatment free survival rate was 56% and the median treatment free survival was 65 months. The baseline percentage of deleted nuclei, as a continuous variable, was related to progression (HR: 1.02; p = 0.001). According to deletion burden, three groups were identified: 64 cases (46%) had <50% deleted nuclei, 47 (33%) had 50-69% deleted nuclei, and 29 (21%) had ≥70% deleted nuclei. The 5-year untreated rate was 70.5% , 52.6% and 28.7% (p < 0.0001), respectively. In multivariate analysis using IGHV mutational status, presence of a nullisomic clone, CD38 expression and percentage of deleted nuclei as covariates, only IGHV mutational status and the percentage of deleted nuclei were independent risk factors for treatment. In 103 patients serially monitored by I-FISH before starting any treatment, we observed a significant increase in the proportion of del13q14 cells, and this increase affected the risk of subsequent treatment requirement (HR 2.54, p = 0.001). The appearance of a new clone was detected in 16 patients (15.5%) and chromosome 13 was involved in 14 of them. I-FISH monitoring proves worthwhile for a dynamic risk stratification and for planning clinical surveillance.
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Affiliation(s)
- Ester M Orlandi
- Department of Oncology-Hematology, Hematology Unit. Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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Marasca R, Maffei R, Martinelli S, Fiorcari S, Bulgarelli J, Debbia G, Rossi D, Rossi FM, Rigolin GM, Martinelli S, Gattei V, Del Poeta G, Laurenti L, Forconi F, Montillo M, Gaidano G, Luppi M. Clinical heterogeneity ofde novo11q deletion chronic lymphocytic leukaemia: prognostic relevance of extent of 11q deleted nuclei inside leukemic clone. Hematol Oncol 2012; 31:88-95. [DOI: 10.1002/hon.2028] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Revised: 09/05/2012] [Accepted: 09/07/2012] [Indexed: 11/06/2022]
Affiliation(s)
- Roberto Marasca
- Division of Hematology, Dipartimento di Scienze Mediche e Chirurgiche Materno-infantili e dell'Adulto; University of Modena and Reggio Emilia; Modena; Italy
| | - Rossana Maffei
- Division of Hematology, Dipartimento di Scienze Mediche e Chirurgiche Materno-infantili e dell'Adulto; University of Modena and Reggio Emilia; Modena; Italy
| | - Silvia Martinelli
- Division of Hematology, Dipartimento di Scienze Mediche e Chirurgiche Materno-infantili e dell'Adulto; University of Modena and Reggio Emilia; Modena; Italy
| | - Stefania Fiorcari
- Division of Hematology, Dipartimento di Scienze Mediche e Chirurgiche Materno-infantili e dell'Adulto; University of Modena and Reggio Emilia; Modena; Italy
| | - Jenny Bulgarelli
- Division of Hematology, Dipartimento di Scienze Mediche e Chirurgiche Materno-infantili e dell'Adulto; University of Modena and Reggio Emilia; Modena; Italy
| | - Giulia Debbia
- Division of Hematology, Dipartimento di Scienze Mediche e Chirurgiche Materno-infantili e dell'Adulto; University of Modena and Reggio Emilia; Modena; Italy
| | - Davide Rossi
- Division of Hematology, Department of Clinical and Experimental Medicine; Amedeo Avogadro University of Eastern Piedmont; Novara; Italy
| | - Francesca Maria Rossi
- Clinical and Experimental Onco-Hematology Unit, Centro di Riferimento Oncologico; I.R.C.C.S.; Aviano; PN; Italy
| | - Gian Matteo Rigolin
- Hematology Section, Department of Biomedical Sciences; Azienda Ospedaliero-Universitaria Arcispedale S. Anna, University of Ferrara; Ferrara; Italy
| | - Sara Martinelli
- Hematology Section, Department of Biomedical Sciences; Azienda Ospedaliero-Universitaria Arcispedale S. Anna, University of Ferrara; Ferrara; Italy
| | - Valter Gattei
- Clinical and Experimental Onco-Hematology Unit, Centro di Riferimento Oncologico; I.R.C.C.S.; Aviano; PN; Italy
| | - Giovanni Del Poeta
- Division of Hematology; S. Eugenio Hospital and University of Tor Vergata; Rome; Italy
| | - Luca Laurenti
- Institute of Hematology; Catholic University of the Sacred Heart; Rome; Italy
| | | | | | - Gianluca Gaidano
- Division of Hematology, Department of Clinical and Experimental Medicine; Amedeo Avogadro University of Eastern Piedmont; Novara; Italy
| | - Mario Luppi
- Division of Hematology, Dipartimento di Scienze Mediche e Chirurgiche Materno-infantili e dell'Adulto; University of Modena and Reggio Emilia; Modena; Italy
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Rodríguez AE, Robledo C, García JL, González M, Gutiérrez NC, Hernández JA, Sandoval V, García de Coca A, Recio I, Risueño A, Martín-Núñez G, García E, Fisac R, Conde J, de Las Rivas J, Hernández JM. Identification of a novel recurrent gain on 20q13 in chronic lymphocytic leukemia by array CGH and gene expression profiling. Ann Oncol 2012; 23:2138-2146. [PMID: 22228453 DOI: 10.1093/annonc/mdr579] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND The presence of genetic changes is a hallmark of chronic lymphocytic leukemia (CLL). The most common cytogenetic abnormalities with independent prognostic significance in CLL are 13q14, ATM and TP53 deletions and trisomy 12. However, CLL displays a great genetic and biological heterogeneity. The aim of this study was to analyze the genomic imbalances in CLL cytogenetic subsets from both genomic and gene expression perspectives to identify new recurrent alterations. PATIENTS AND METHODS The genomic imbalances and expression levels of 67 patients were analyzed. The novel recurrent abnormalities detected with bacterial artificial chromosome array were confirmed by FISH and oligonucleotide microarrays. In all cases, gene expression profiling was assessed. RESULTS Copy number alterations were identified in 75% of cases. Overall, the results confirmed FISH studies for the regions frequently involved in CLL and also defined a new recurrent gain on chromosome 20q13.12, in 19% (13/67) of the CLL patients. Oligonucleotide expression correlated with the regions of loss or gain of genomic material, suggesting that the changes in gene expression are related to alterations in copy number. CONCLUSION Our study demonstrates the presence of a recurrent gain in 20q13.12 associated with overexpression of the genes located in this region, in CLL cytogenetic subgroups.
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Affiliation(s)
- A E Rodríguez
- IBMCC, Centro de Investigación del Cáncer, Universidad de Salamanca-CSIC, Salamanca
| | - C Robledo
- IBMCC, Centro de Investigación del Cáncer, Universidad de Salamanca-CSIC, Salamanca
| | - J L García
- Instituto de Estudios de Ciencias de la Salud de Castilla y León (IECSCYL)-HUSAL, Castill y León
| | - M González
- Department of Hematology, Hospital Clínico Universitario de Salamanca, Salamanca
| | - N C Gutiérrez
- Department of Hematology, Hospital Clínico Universitario de Salamanca, Salamanca
| | - J A Hernández
- Department of Hematology, Hospital Infanta Leonor, Madrid
| | - V Sandoval
- Department of Hematology, Hospital Virgen Blanca, León
| | - A García de Coca
- Department of Hematology, Hospital Clínico Universitario, Valladolid
| | - I Recio
- Department of Hematology, Hospital Nuestra Señora de Sonsoles, Ávila
| | - A Risueño
- Bioinformatics and Functional Genomics, Centro de Investigación del Cáncer, Universidad de Salamanca-CSIC, Salamanca
| | - G Martín-Núñez
- Department of Hematology, Hospital Virgen del Puerto, Plasencia
| | - E García
- Genomics and Proteomics Unit, Centro de Investigación del Cáncer, Universidad de Salamanca-CSIC, Salamanca
| | - R Fisac
- Department of Hematology, Hospital General de Segovia, Segovia
| | - J Conde
- Department of Hematology, Hospital del Río Hortega, Valladolid, Spain
| | - J de Las Rivas
- Bioinformatics and Functional Genomics, Centro de Investigación del Cáncer, Universidad de Salamanca-CSIC, Salamanca
| | - J M Hernández
- IBMCC, Centro de Investigación del Cáncer, Universidad de Salamanca-CSIC, Salamanca; Department of Hematology, Hospital Clínico Universitario de Salamanca, Salamanca.
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Garg R, Wierda W, Ferrajoli A, Abruzzo L, Pierce S, Lerner S, Keating M, O’Brien S. The prognostic difference of monoallelic versus biallelic deletion of 13q in chronic lymphocytic leukemia. Cancer 2012; 118:3531-7. [PMID: 22139735 PMCID: PMC4535912 DOI: 10.1002/cncr.26593] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2011] [Revised: 06/02/2011] [Accepted: 07/11/2011] [Indexed: 11/06/2022]
Abstract
BACKGROUND Fluorescence in situ hybridization can detect genomic abnormalities in up to 80% of cases and provides prognostic information on patients with chronic lymphocytic leukemia (CLL). Although 13q deletion as the sole abnormality has been found to confer a favorable prognosis, there are little data as to whether there is a difference in prognostic value between monoallelic versus biallelic deletion of 13q. METHODS The authors reviewed the electronic database for patients with CLL who carried the 13q deletion as the sole abnormality and presented to The University of Texas MD Anderson Cancer Center (MDACC). Untreated patients were separated into 2 groups: those having monoallelic versus those with biallelic deletion of 13q. Using Mann-Whitney, chi-square, and Kaplan-Meier analysis, the baseline quantitative and qualitative variables for each group, along with the time from presentation to MDACC to treatment, were compared. RESULTS A total of 176 patients were identified; 143 patients had a monoallelic deletion of 13q, whereas 33 patients had a biallelic deletion. The only significantly different values between the groups were albumin (4.5 g/dL vs 4.4 g/dL; P = .01) and zeta-chain-associated protein kinase 70 (ZAP70) expression (1.7% vs 4.8%; P = .010). The median time from fluorescence in situ hybridization analysis to treatment in both the monoallelic and biallelic groups had not been reached (P = not significant). CONCLUSIONS Except for inconsequential differences in albumin and ZAP70 expression, there was no difference in the baseline characteristics between patients with CLL who had monoallelic or biallelic deletion of 13q. In addition, there was no significant difference in endpoints, including time to treatment.
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Affiliation(s)
- Ravin Garg
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - William Wierda
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Alessandra Ferrajoli
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Lynne Abruzzo
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Sherry Pierce
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Susan Lerner
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Michael Keating
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Susan O’Brien
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
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Kiefer Y, Schulte C, Tiemann M, Bullerdiek J. Chronic lymphocytic leukemia-associated chromosomal abnormalities and miRNA deregulation. APPLICATION OF CLINICAL GENETICS 2012; 5:21-8. [PMID: 23776377 PMCID: PMC3681189 DOI: 10.2147/tacg.s18669] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Chronic lymphocytic leukemia is the most common leukemia in adults. By cytogenetic investigations major subgroups of the disease can be identified that reflect different routes of tumor development. Of these chromosomal deviations, trisomy 12 and deletions of parts of either the long arm of chromosome 13, the long arm of chromosome 11, or the short arm of chromosome 17 are most commonly detected. In some of these aberrations the molecular target has been identified as eg, ataxia telangiectasia mutated (ATM) in case of deletions of chromosomal region 11q22~23 and the genes encoding microRNAs miR-15a/16-1 as likely targets of deletions of chromosomal band 13q14.3. Of note, these aberrations do not characterize independent subgroups but often coexist within the metaphases of one tumor. Generally, complex aberrations are associated with a worse prognosis than simple karyotypic alterations. Due to smaller sizes of the missing segment the detection of recurrent deletions is not always possible by means of classical cytogenetics but requires more advanced techniques as in particular fluorescence in situ hybridization (FISH). Nevertheless, at this time it is not recommended to replace classical cytogenetics by FISH because this would miss additional information given by complex or secondary karyotypic alterations. However, the results of cytogenetic analyses allow the stratification of prognostic and predictive groups of the disease. Of these, the group characterized by deletions involving TP53 is clinically most relevant. In the future refined methods as eg, array-based comparative genomic hybridization will supplement the existing techniques to characterize CLL.
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Affiliation(s)
- Yvonne Kiefer
- Center for Human Genetics, University of Bremen, Bremen, Germany
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Hernández JM, Granada I, Solé F. [From conventional cytogenetics to microarrays. Fifty years of Philadelphia chromosome]. Med Clin (Barc) 2011; 137:221-9. [PMID: 20591449 DOI: 10.1016/j.medcli.2010.04.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2010] [Accepted: 04/27/2010] [Indexed: 11/16/2022]
Abstract
In 1960 Ph-chromosome was found associated with the presence of chronic myelogenous leukemia. In these 50 years an increasing number of cytogenetic abnormalities have been found associated with hematological malignancies. The presence of these abnormalities is not only important for the diagnosis of the patient, but it also contributes to the prognosis of patients with leukemia or lymphoma. For this reason the WHO classification of hematological disease has included these studies for the correct characterization of leukemias and lymphomas. In addition, the use of FISH and micromatrix methodologies have refined the genetic lesions present in these malignancies. The cytogenetic changes observed also provide further information in relation to the therapy.
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Affiliation(s)
- Jesús M Hernández
- Servicio de Hematología, Hospital Universitario de Salamanca y Unidad de Diagnóstico Molecular y Celular del Cáncer, Instituto de Biología Molecular y Celular del Cáncer (IBMCC), Centro de Investigación del Cáncer, Universidad de Salamanca, Salamanca, España.
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Mian M, Rinaldi A, Mensah AA, Rossi D, Ladetto M, Forconi F, Marasca R, Gattei V, Zucca E, Cavalli F, Gaidano G, Kwee I, Bertoni F. Del(13q14.3) length matters: an integrated analysis of genomic, fluorescence in situ hybridization and clinical data in 169 chronic lymphocytic leukaemia patients with 13q deletion alone or a normal karyotype. Hematol Oncol 2011; 30:46-9. [DOI: 10.1002/hon.997] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2010] [Revised: 02/17/2011] [Accepted: 03/22/2011] [Indexed: 11/11/2022]
Affiliation(s)
| | - Andrea Rinaldi
- Laboratory of Experimental Oncology and Lymphoma Unit; Oncology Institute of Southern Switzerland (IOSI); Bellinzona; Switzerland
| | - Afua Adjeiwaa Mensah
- Laboratory of Experimental Oncology and Lymphoma Unit; Oncology Institute of Southern Switzerland (IOSI); Bellinzona; Switzerland
| | - Davide Rossi
- Division of Hematology-Department of Clinical and Experimental Medicine & IRCAD; Amedeo Avogadro University of Eastern Piedmont; Novara; Italy
| | | | - Francesco Forconi
- Division of Hematology and Transplant, Department of Clinical Medicine and Immunological Sciences; University of Siena; Siena; Italy
| | - Roberto Marasca
- Division of Hematology, Department of Oncology and Hematology; University of Modena and Reggio Emilia; Modena; Italy
| | - Valter Gattei
- Clinical and Experimental Onco-Hematology Unit; Centro di Riferimento Oncologico, I.R.C.C.S.; Aviano; PN; Italy
| | - Emanuele Zucca
- Laboratory of Experimental Oncology and Lymphoma Unit; Oncology Institute of Southern Switzerland (IOSI); Bellinzona; Switzerland
| | - Franco Cavalli
- Laboratory of Experimental Oncology and Lymphoma Unit; Oncology Institute of Southern Switzerland (IOSI); Bellinzona; Switzerland
| | - Gianluca Gaidano
- Division of Hematology; Azienda Ospedaliera S. Maurizio; Bolzano/Bozen; Italy
| | | | - Francesco Bertoni
- Laboratory of Experimental Oncology and Lymphoma Unit; Oncology Institute of Southern Switzerland (IOSI); Bellinzona; Switzerland
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Dal Bo M, Rossi FM, Rossi D, Deambrogi C, Bertoni F, Del Giudice I, Palumbo G, Nanni M, Rinaldi A, Kwee I, Tissino E, Corradini G, Gozzetti A, Cencini E, Ladetto M, Coletta AM, Luciano F, Bulian P, Pozzato G, Laurenti L, Forconi F, Di Raimondo F, Marasca R, Del Poeta G, Gaidano G, Foà R, Guarini A, Gattei V. 13q14 deletion size and number of deleted cells both influence prognosis in chronic lymphocytic leukemia. Genes Chromosomes Cancer 2011; 50:633-43. [PMID: 21563234 DOI: 10.1002/gcc.20885] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2011] [Revised: 03/25/2011] [Accepted: 03/27/2011] [Indexed: 01/27/2023] Open
Abstract
Deletion at 13q14 is detected by fluorescence in situ hybridization (FISH) in about 50% of chronic lymphocytic leukemia (CLL). Although CLL with 13q deletion as the sole cytogenetic abnormality (del13q-only) usually have good prognosis, more aggressive clinical courses are documented for del13q-only CLL carrying higher percentages of 13q deleted nuclei. Moreover, deletion at 13q of different sizes have been described, whose prognostic significance is still unknown. In a multi-institutional cohort of 342 del13q-only cases and in a consecutive unselected cohort of 265 CLL, we investigated the prognostic significance of 13q deletion, using the 13q FISH probes locus-specific identifier (LSI)-D13S319 and LSI-RB1 that detect the DLEU2/MIR15A/MIR16-1 and RB1 loci, respectively. Results indicated that both percentage of deleted nuclei and presence of larger deletions involving the RB1 locus cooperated to refine the prognosis of del13q-only cases. In particular, CLL carrying <70% of 13q deleted nuclei with deletions not comprising the RB1 locus were characterized by particularly long time-to-treatment. Conversely, CLL with 13q deletion in <70% of nuclei but involving the RB1 locus, or CLL carrying 13q deletion in ≥70% of nuclei, with or without RB1 deletions, collectively experienced shorter time-to-treatment. A revised flowchart for the prognostic FISH assessment of del13q-only CLL, implying the usage of both 13q probes, is proposed.
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Affiliation(s)
- Michele Dal Bo
- Clinical and Experimental Onco-Hematology Unit, Centro di Riferimento Oncologico, IRCCS, Aviano (PN), Italy
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Hernández JA, González M, Hernández JM. [Chronic lymphocytic leukemia]. Med Clin (Barc) 2009; 135:172-8. [PMID: 20045138 DOI: 10.1016/j.medcli.2009.10.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2009] [Revised: 10/11/2009] [Accepted: 10/15/2009] [Indexed: 11/17/2022]
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Van Dyke DL, Shanafelt TD, Call TG, Zent CS, Smoley SA, Rabe KG, Schwager SM, Sonbert JC, Slager SL, Kay NE. A comprehensive evaluation of the prognostic significance of 13q deletions in patients with B-chronic lymphocytic leukaemia. Br J Haematol 2009; 148:544-50. [PMID: 19895615 DOI: 10.1111/j.1365-2141.2009.07982.x] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Deletion 13q14 on fluorescence in situ hybridization (FISH) analysis is the most common cytogenetic abnormality in chronic lymphocytic leukaemia (CLL), and is a favourable prognostic biomarker when detected as a sole abnormality. We intensively interrogated clinical outcome in 323 consecutive, untreated CLL patients with isolated 13q- identified within 2 years of diagnosis. We also analyzed outcome in 217 additional patients with deletion 11q22.3 or 17p13.1, or trisomy 12, based on whether these occurred in isolation or in conjunction with 13q-. Patients with a heterozygous 13q- and those with a homozygous deletion had similar time to first treatment (TFT) and overall survival (OS). In contrast, a higher percentage of 13q- nuclei was associated with significantly shorter TFT (P < 0.001). The 5-year untreated rate was 79% for patients with isolated 13q- in < or =65.5% of nuclei compared to 38% among those with 13q- in >65.5% of nuclei (P < 0.001). The percentage of nuclei exhibiting 13q- remained an independent predictor of TFT after controlling for ZAP-70, IGHV, or CD38 (all P < 0.001). Among patients with 13q- plus one other FISH abnormality, concomitant 13q- appeared to attenuate the shorter survival associated with 17p- (P = 0.019). The clinical implications of 13q- in CLL appear more complex than originally appreciated.
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Affiliation(s)
- Daniel L Van Dyke
- Division of Laboratory Genetics, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
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