Binet’s Staging System and VH Genes Are Independent but Complementary Prognostic Indicators in Chronic Lymphocytic Leukemia

Abstract

The significant survival differences observed between the VH mutational groups, among stage A and stage B and C patients, indicate that Binet's classification and VH genes are independent prognostic variables and are most likely complementary.

Autoimmune hemolytic anemia in patients with chronic lymphocytic leukemia is associated with IgVH status

“…In comparison only 10 of 35 (28%) controls showed un-mutated IgVH, as expected in an unselected cohort. 8 The odds ratio of developing autoimmune hemolytic anemia in un-mutated chronic lymphocytic leukemia could be estimated as 4.79 (95% CI 1.74-13.18, P=0.001 by Fisher's exact test). No significant difference was observed in VH family distribution between the two groups, with VH3 family being the most represented among patients with autoimmune hemolytic anemia (66%; Table 1).…”

Deregulated expression of fat and muscle genes in B-cell chronic lymphocytic leukemia with high lipoprotein lipase expression

“…1,3,11,12 Subsequently, considerable differences in gene expression were linked to various discriminators between good and poor risk B-CLL: these include cytogenetic aberrations, 13,14 expression of the CD38 protein, 15,16 the expression of microRNAs, 17,18 and most importantly, immunoglobulin V H gene (IgV H ) mutational status. 15,16,[19][20][21][22][23][24][25] The first practical result emerging from these studies was the identification of a novel prognostic marker, the ZAP-70 protein, which has already entered routine diagnostics. 3,4,9,[26][27][28][29][30][31] However, microarray analysis has identified a number of other potential prognostic or therapeutic targets that have not yet been validated for their clinical importance.…”

Un-mutated IgVH in chronic lymphocytic leukemia is associated with a higher risk of immune thrombocytopenia

“…For comparison only six out of 20 (30%) of controls showed un-mutated IgVH, a figure consistent with their early RAI stage. 3 The odds ratio of developing IT in un-mutated CLL could be estimated as 9.33 (95% CI 1.82-52.6, P ¼ 0.001). In addition, in patients who developed IT we found an excess of VH1 and VH3 families without any case of VH4, usually reported as one of the most frequent gene assortment in CLL 4,5 (P ¼ 0.0004, by w 2 test, see Table 1).…”