Prospective study of clinical and biological prognostic factors at diagnosis in patients with early stage B-cell chronic lymphocytic leukemia.

Retrospective series have reported many clinical and biological significant prognostic factors in chronic lymphocytic leukemia (CLL). We describe a prospective cohort of 135 patients with CLL homogeneously studied at diagnosis for prognostic factors. Biological variables analyzed were CD38 and ZAP-70 expression, fluorescence in situ hybridization (FISH) for 13q−−, ++12, 11q−−, and 17p−−, and conventional cytogenetics. Univariate and multivariate analysis for progression-free survival (PFS) were performed in patients with early stage (Rai 0--1) CLL. CD38 was positive in 42 (31.6%%) patients and ZAP-70 in 47 (35.9%%). The most frequent FISH finding was isolated 13q−− in 50 (38.5%%) patients, and 17p−− was found in 11 (8.4%%). Among 135 patients, 114 (84.4%%) were Rai 0--1 at diagnosis and 39 (28.9%%) presented adenopathies. With a median follow-up of 39 months, the presence of lymphadenopathy in patients with Rai 0--1 stage CLL was the only significant variable for predicting PFS in multivariate analysis (odds ratio [[OR]] 7, 95%% confidence interval [[CI]] 2.2--22, p == 0.001). When only biological factors were analyzed, CD38 expression (OR 3.2, 95%% CI 1.1--9.3, p == 0.03) and 17p−− (OR 3.5, 95%% CI 0.95--13.1, p == 0.05) correlated with worse PFS. A longer follow-up is necessary to analyze the prognostic value of these variables regarding overall survival. [ABSTRACT FROM AUTHOR]