In:
European Journal of Haematology, Wiley, Vol. 83, No. 3 ( 2009-09), p. 208-214
Abstract:
We analyzed the correlation between well‐established biological parameters of prognostic relevance in B‐cell chronic lymphocytic leukemia (CLL) [i.e. mutational status of the immunoglobulin heavy chain variable region (IgV H ), ZAP‐70‐ and CD38‐expression] and serum levels of CD26 (dipeptidyl peptidase IV, DPP IV) by evaluating the impact of these variables on the time to first treatment (TFT) in a series of 69 previously untreated Binet stage A B‐cell CLL patients. By using a commercial ELISA we found that with exception of a borderline significance for ZAP‐70 ( P = 0.07) and CD38 ( P = 0.08), circulating levels of CD26 did not correlate with either Rai substages ( P = 0.520) or other biomarker [β2‐microglobulin ( P = 0.933), LDH ( P = 0.101), mutational status of IgV H ( P = 0.320)]. Maximally selected log‐rank statistic plots identified a CD26 serum concentration of 371 ng/mL as the best cut‐off. This threshold allowed the identification of two subsets of patients with CD26 serum levels higher and lower that 371 ng/mL respectively, whose clinical outcome was different with respect to TFT (i.e. 46% and 71% at 5 yr respectively; P = 0.005). Along with higher serum levels of CD26, the univariate Cox proportional hazard model identified absence of mutation in IgV H ( P 〈 0.0001) as predictor of shorter TFT. As in multivariate analysis all these parameters maintained their discriminating power (mutational status of IgV H, P 〈 0.0001; soluble CD26, P = 0.02) their combined effect on clinical outcome was assessed. When three groups were considered: (1) Low‐risk group ( n = 31), patients with concordant IgVH mut and low level of soluble CD26; (2) intermediate risk group ( n = 26), patients with discordant pattern; (3) high‐risk group ( n = 12), patients with concordant IgVH unmut and high level of soluble CD26, differences in the TFT were statistically significant, with a TFT at 5 yr of respectively 88%, 51% and 43% ( P 〈 0.0001). Our results indicate that in early B‐cell CLL biological profile including among other parameters soluble CD26 may provide a useful insight into the complex interrelationship of prognostic variables. Furthermore, CD26 along with mutational status of IgV H can be adequately used to predict clinical behavior of patients with low risk disease.
Type of Medium:
Online Resource
ISSN:
0902-4441
,
1600-0609
DOI:
10.1111/ejh.2009.83.issue-3
DOI:
10.1111/j.1600-0609.2009.01273.x
Language:
English
Publisher:
Wiley
Publication Date:
2009
detail.hit.zdb_id:
2027114-1
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