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Prepublished online as a Blood First Edition Paper on April 3, 2003; DOI 10.1182/blood-2002-12-3639. This Article Full Text Full Text (PDF) All Versions of this Article: 2002-12-3639v1 102/3/1035    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Guarini, A. Articles by Foa, R. Search for Related Content PubMed PubMed Citation Articles by Guarini, A. Articles by Foa, R. Related Collections Immunobiology Neoplasia Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  Blood, 1 August 2003, Vol. 102, No. 3, pp. 1035-1041 NEOPLASIA Chronic lymphocytic leukemia patients with highly stable and indolent disease show distinctive phenotypic and genotypic features Anna Guarini, Gianluca Gaidano, Francesca Romana Mauro, Daniela Capello, Francesca Mancini, Maria Stefania De Propris, Marco Mancini, Enrica Orsini, Massimo Gentile, Massimo Breccia, Antonio Cuneo, Gianluigi Castoldi, and Robert Foa From the Dipartimento di Biotecnologie Cellulari ed Ematologia, Università La Sapienza, Roma, Italy; Unità Didattico Assistentiale (UDA) Ematologia, Dipartimento di Scienze Mediche & Interdisciplinary Research Center on Autoimmune Diseases (IRCAD), Università del Piemonte Orientale Amedeo Avogadro, Novara, Italy; and Dipartimento di Scienze Biomediche e Terapie Avanzate, Università degli Studi, Ferrara, Italy Different biologic features have been associated with a more or less aggressive clinical course in chronic lymphocytic leukemia (CLL). In the present study, 20 patients with highly stable CLL observed at a single institution over a period of 10 to 23 years and who never required treatment were extensively characterized. The aim was to identify a distinct and reproducible biologic profile associated with disease stability that may be used to recognize at presentation CLL patients who are likely to have a very benign clinical course and for whom treatment is not indicated. The results obtained indicate that numerous parameters are closely associated with disease stability: a typical CLL morphology and immunophenotype, the lack of expression of the CD38 antigen, the mutated immunoglobulin (Ig) heavy (H) chain variable (V) pattern, the absence of p53 mutations, a CD4/CD8 ratio more than 1, the lack of 17p and 11q deletions and of complex karyotypic aberrations, and the occurrence of the 13q14 deletion. No case displayed the VH3-21 gene, linked in mutated CLL with a poor outcome. In addition, the VH1-69 gene associated with unmutated CLL cases was never detected. These biologic features were coupled with an indolent clinical course characterized by an unmodified clinical stage over time, and by lack of autoimmune phenomena and of major infections requiring parental antibiotics. At a time when aggressive therapeutic strategies are always more frequently used in the management of CLL, the distinctive features of patients with long-lived stable disease should be prospectively identified at presentation. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: G. S. Sellick, R. Wade, S. Richards, D. G. Oscier, D. Catovsky, and R. S. Houlston Scan of 977 nonsynonymous SNPs in CLL4 trial patients for the identification of genetic variants influencing prognosis Blood, February 1, 2008; 111(3): 1625 - 1633. [Abstract] [Full Text] [PDF] V. Fulci, S. Chiaretti, M. Goldoni, G. Azzalin, N. Carucci, S. Tavolaro, L. Castellano, A. Magrelli, F. Citarella, M. Messina, et al. Quantitative technologies establish a novel microRNA profile of chronic lymphocytic leukemia Blood, June 1, 2007; 109(11): 4944 - 4951. [Abstract] [Full Text] [PDF]

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