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Clonal evolution including 14q32/IGH translocations in chronic lymphocytic leukemia: analysis of clinicobiologic correlations in 105 patients.
- Source :
-
Leukemia & lymphoma [Leuk Lymphoma] 2012 Jan; Vol. 53 (1), pp. 83-8. Date of Electronic Publication: 2011 Sep 13. - Publication Year :
- 2012
-
Abstract
- To better define the significance of clonal evolution (CE) including 14q32 translocations involving the immunoglobulin heavy chain gene (IGH) in chronic lymphocytic leukemia (CLL), 105 patients were analyzed sequentially by fluorescence in situ hybridization (FISH) with the following panel of probes: 13q14/D13S25, 11q22/ATM, 17p13/TP53, #12-centromere and 14q32/IGH break-apart probe. CE was observed in 15/105 patients after 24-170 months (median 64). Recurring aberrations at CE were 14q32/IGH translocation in seven patients; other aberrations were 17p -, 11q -, biallelic 13q - and 14q32 deletion. CE was detected in 15/58 pre-treated patients; in contrast, none of 47 untreated patients developed CE (p < 0.0001). In two cases the appearance of 14q32/IGH translocation was first detected in the bone marrow (BM) or in the lymph node (LN) and 13-58 months later in the peripheral blood (PB). ZAP70 + and high-risk cytogenetics predicted for the occurrence of CE with borderline statistical significance (p = 0.055 and 0.07, respectively). Shorter time to first treatment (TTT) and time to chemorefractoriness (TTCR) were noted in 15 patients with CE when compared to patients without CE (TTT: 35 vs. 71 months, p = 0.0033 and TTCR: 34 vs. 86 months, p = 0.0046, respectively). Survival after the development of CE was 32 months (standard error 8.5). We arrived at the following conclusions: (i) 14q32/IGH translocation may represent one of the most frequent aberrations acquired during the natural history of CLL and (ii) it may be detected earlier in BM or LN samples; (iii) CE including 14q32/IGH translocation occurs in pre-treated patients with short TTT and TTCR; (iii) survival after CE is relatively short.
- Subjects :
- Adult
Aged
Aged, 80 and over
Chromosome Aberrations
Female
Humans
In Situ Hybridization, Fluorescence statistics & numerical data
Karyotyping
Leukemia, Lymphocytic, Chronic, B-Cell drug therapy
Male
Middle Aged
Proportional Hazards Models
Survival Analysis
Time Factors
ZAP-70 Protein-Tyrosine Kinase genetics
Chromosomes, Human, Pair 14 genetics
Clonal Evolution
Immunoglobulin Heavy Chains genetics
Leukemia, Lymphocytic, Chronic, B-Cell genetics
Translocation, Genetic
Subjects
Details
- Language :
- English
- ISSN :
- 1029-2403
- Volume :
- 53
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Leukemia & lymphoma
- Publication Type :
- Academic Journal
- Accession number :
- 21767243
- Full Text :
- https://doi.org/10.3109/10428194.2011.606384