| Affiliation: | 1.Department of Hematology, The First Affiliated Hospital of Nanjing Medical University,Jiangsu Province Hospital,Nanjing,China;2.Key Laboratory of Hematology of Nanjing Medical University,Nanjing,China;3.Collaborative Innovation Center for Cancer Personalized Medicine,Nanjing,China;4.Department of Hematology,The First People’s Hospital of Yancheng,Yancheng,China |
| Abstract: | Previous studies showed that, in chronic lymphocytic leukemia (CLL) patients with isolated 13q deletion (13q-), those carrying higher percentage of leukemic cells with 13q- had more aggressive diseases. However, the prognostic value of the percentage of leukemic cells with 13q- in Chinese CLL patients with isolated 13q- remained to be determined. Using interphase fluorescence in situ hybridization (FISH), we identified 82 patients (25.4%) with isolated 13q deletion from a cohort of 323 untreated CLL patients. Among patients with isolated 13q deletion, cases of 13q- cells ≥?80% (13q-H) had significantly shorter time to first treatment (TTT) than those of p?=?0.0016). A higher lymphocyte count (p?=?0.0650) was associated with 13q-H, while other clinical, immunophenotypic, or molecular features did not differ between patients with 13q-H and 13q-L. Although 13q-H only showed marginal significance in multivariate analysis of TTT (hazards ratio 2.007; 95% confidence interval 0.975–4.129; p?=?0.059), it helped refine the risk stratification based on Binet stage or immunoglobulin heavy chain variable gene (IGHV) status. In cases in Binet A or B stage, patients with 13q-H had a significantly shorter TTT (median TTT 18 months vs. undefined, p?=?0.0101). And in IGHV mutated patients, 13q-H was also associated with reduced TTT (median TTT 13q-H. 18 months vs. 13q-L undefined, p?=?0.0163). In conclusion, the prognosis of CLL patients with isolated 13q deletion was heterogeneous with 13q-H identifying patients with worse outcome. |
