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Blood, 15 July 2005, Vol. 106, No. 2, pp. 650-657.
Prepublished online as a Blood First Edition Paper on March 31, 2005; DOI 10.1182/blood-2004-08-3344.
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NEOPLASIA
The LPL/ADAM29 expression ratio is a novel prognosis indicator in chronic lymphocytic leukemia
Pablo Oppezzo,
Yuri Vasconcelos,
Catherine Settegrana,
Dominique Jeannel,
Françoise Vuillier,
Magali Legarff-Tavernier,
Eliza Yuriko Kimura,
Stéphane Bechet,
Gérard Dumas,
Martine Brissard,
Hélène Merle-Béral,
Mihoko Yamamoto,
Guillaume Dighiero,
Frédéric Davi, for the French Cooperative Group on CLL
From the Unité d'Immuno-Hématologie et d'Immunopathologie, Institut Pasteur, Paris, France; Disciplina de Hematologia e Hemoterapia, Universidade Federal de São Paulo, São Paulo, Brazil; Service d'Hématologie Biologique, Hôpital Pitié-Salpêtrière, Paris, France; Département des Ecosystèmes et Epidémiologie des Maladies Infectieuses, Institut Pasteur, Paris, France; Service Immunologie, Hôpital Pitié-Salpêtrière, Paris, France; and Centre de Recherche Vaccinale et Biomédicale, Institut Pasteur, Paris, France.
Although the zeta-associated protein of 70 kDa (ZAP-70) is overexpressed in patients with chronic lymphocytic leukemia (CLL) displaying unmutated IGVH genes and poor prognosis, a previous microarray study from our group identified overexpression of LPL and ADAM29 genes among unmutated and mutated CLL, respectively. To assess the prognostic value of these genes, we quantified their expression by real-time quantitative polymerase chain reaction (PCR) in a cohort of 127 patients with CLL and correlated this with clinical outcome, IGVH mutational status, and ZAP-70 protein expression. IGVH mutational status, ZAP-70, and the LPL and ADAM29 mRNA ratios (L/A ratio) were predictive of event-free survival for the whole cohort and for patients with stage A disease. In patients in stage B and C, the L/A ratio was an independent prognostic factor, whereas ZAP-70 did not predict survival. Simultaneous usage of the L/A ratio and ZAP-70 expression allowed an almost perfect (99%) assessment of the IGVH status in the 80% of patients with concordant results (L/A+, ZAP-70+ or L/A-, ZAP-70-). LPL and ADAM29 gene expression could also be determined by a simple competitive multiplex reverse transcription PCR assay. Overall, quantification of LPL and ADAM29 gene expression is a strong prognostic indicator in CLL, providing better prognostic assessment than ZAP-70 in advanced stages of the disease. (Blood. 2005;106:650-657)
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