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Introduction: Among patients with indolent form of B-cell chronic lymphocytic leukemia, some of them will progress into more advanced stages. To better define this subpopulation of patients, we attempted to define some parameters capable of predicting a pejorative clinical outcome. Materials and methods: Eighty-eight previously untreated patients with B-cell chronic lymphocytic leukemia in Binet stage A were analysed to study the prognostic value of simple serological variables: soluble CD23 (sCD23), b2 microglobulin (b2m), lactate-dehydrogenase activities and albumin level. Results were compared to other conventional clinical and biological parameters by univariate and multivariate statistical analysis. Results: Our data show that: (1) among those studied, sCD23 450 u/ml was the only serological significant parameter clearly correlated with disease progression and (2) stage A’’ patients (hemoglobin level between 100 and 120 g/l and/or lymphocytosis 430.10 9 /l), axillary lymph nodes and hypogammaglobulinemia were found to be other variables associated with a pejorative outcome. These four variables enabled the establishment of a scoring system, capable of predicting disease progression since 66% of the patients with a score 42 are going to evolve into advanced stages vs 12% with a score 52. Furthermore, the time to progression is shortened when the score is increasing. Conclusion: Our findings show the prognostic relevance of a scoring system including sCD23 level. This score could be taken into account in the treatment strategy of B-cell chronic lymphocytic leukemia. The Hematology Journal (2000) 1, 301‐306

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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. Hop La Pitie Salpetriere, Serv Hematol Biol, F-75013 Paris, France Inst Pasteur, Unite Immunohematol & Immunopathol, F-75724 Paris, France Universidade Federal de São Paulo, Disciplina Hematol & Hemoterapia, São Paulo, Brazil Inst Pasteur, Dept Ecosyst & Epidemiol Malad Infect, Paris, France Hop La Pitie Salpetriere, Serv Immunol, Paris, France Inst Pasteur, Ctr Rech Vaccinale & Biomed, Paris, France Universidade Federal de São Paulo, Disciplina Hematol & Hemoterapia, São Paulo, Brazil Web of Science

Biol Regul Homeost Agents. 2004 Jul-Dec;18(3-4):392-8. Immunophenotypic approach to the identification and characterization of clonal plasma cells from patients with monoclonal gammopathies. Pérez-Andrés M, Santiago M, Almeida J, Mateo G, Porwit-MacDonald A, Bjorklund E, Valet G, Kraan J, Gratama JW, D'Hautcourt JL, Merle-Beral H, Lima M, Montalban MA, San Miguel JF, Orfao I; European Working Group on Clinical Cell Analysis; Spanish Network on Multiple Myeloma. Service of Cytometry, Centro de Investigación del Cáncer, Salamanca, Spain. PMID: 15786710 [PubMed - indexed for MEDLINE]

Human T lymphotropic virus type II (HTLV-II), originally isolated in 1982 from a patient with a "T hairy cell leukemia", has not yet been proven to be the causative agent of any specific hematological disease. In order to screen for such an event, and because HTLV-II has a preferential tropism for OKT8 (CD8) T cells (both in vivo and in vitro), we searched for the presence of HTLV-II in lymphoproliferative diseases (LP) of CD8+ T cells. We report a serological and/or molecular study of 169 patients with a T CD8 LP, including 76 patients with malignant or reactive T CD8 LP (34 lymphomas, 27 large granular leukemias, three prolymphocytic leukemias, one hairy cell leukemia, 11 reactive T CD8 LP) and 93 HIV-1+ patients with a T CD8 peripheral lymphocytosis (1500/mm3) from a prospective HIV cohort involving 1264 individuals. In the first series, the 40 sera available were all HTLV-I/II negative, except a 67-year-old French Guyanan man, with a cutaneous large T CD8 cell lymphoma, HTLV-I+. Furthermore, the molecular analysis of the 69 available DNA samples by PCR failed to detect any proviral HTLV-I/II sequences, except for the HTLV-I+ patient. The serological study of the 93 HIV-1+ individuals with CD8 lymphocytosis, showed that three patients were HTLV-I+, but none was HTLV-II+. Thus, in contrast to HTLV-I, whose etiological role in adult T cell leukemia is now well established, there is neither epidemiological nor molecular evidence that prototypic HTLV-II may be etiologically associated specifically with any of the CD8+ T cell LP investigated in this report.