Not all IGHV3-21 chronic lymphocytic leukemias are equal: prognostic considerations
| Authors | |
|---|---|
| Year of publication | 2015 |
| Type | Article in Periodical |
| Magazine / Source | Blood |
| MU Faculty or unit | |
| Citation | |
| web | http://www.bloodjournal.org/content/125/5/856?sso-checked=true |
| Doi | http://dx.doi.org/10.1182/blood-2014-09-600874 |
| Field | Oncology and hematology |
| Keywords | B-CELL RECEPTORS; GENE MUTATIONAL STATUS; CD38 EXPRESSION; PATHOGENETIC IMPLICATIONS; GENOMIC ABERRATIONS; PATTERNS; SUBSETS; SELECTION; DISEASE |
| Attached files | |
| Description | An unresolved issue in chronic lymphocytic leukemia (CLL) is whether IGHV3-21 gene usage, in general, or the expression of stereotyped B-cell receptor immunoglobulin defining subset # 2 (IGHV3-21/IGLV3-21), in particular, determines outcome for IGHV3-21-utilizing cases. We reappraised this issue in 8593 CLL patients of whom 437 (5%) used the IGHV3-21 gene with 254/437 (58%) classified as subset # 2. Within subset # 2, immunoglobulin heavy variable (IGHV)-mutated cases predominated, whereas non-subset # 2/IGHV3-21 was enriched for IGHV-unmutated cases (P =.002). Subset # 2 exhibited significantly shorter time-to-first-treatment (TTFT) compared with non-subset # 2/IGHV3-21 (22 vs 60 months, P =.001). No such difference was observed between non-subset # 2/IGHV3-21 vs the remaining CLL with similar IGHV mutational status. In conclusion, IGHV3-21 CLL should not be axiomatically considered a homogeneous entity with adverse prognosis, given that only subset # 2 emerges as uniformly aggressive, contrasting non-subset # 2/IGVH3-21 patients whose prognosis depends on IGHV mutational status as the remaining CLL. |
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