Del Poeta G.,University of Rome Tor Vergata |
Del Principe M.I.,University of Rome Tor Vergata |
Maurillo L.,University of Rome Tor Vergata |
Rossi F.M.,Clinical and Experimental Hematology Unit |
And 11 more authors.
Leukemia and Lymphoma | Year: 2010
In chronic lymphocytic leukemia (CLL), inhibition of spontaneous apoptosis determines a worse prognosis and increasing evidences show that disease progression relies also upon cycling CLL cells. We investigated bcl-2, as measure of apoptosis, and CD71, as measure of proliferation, by flow cytometry in 265 patients with CLL. Combining bcl-2 with CD71 values, we defined three subgroups: (1) bcl2-CD717; (2) bcl2+CD71+; and (3) bcl2+CD717 - or bcl2-CD71+. Both a shorter progression-free survival (PFS) and overall survival (OS) were observed in ZAP-70+ (p<.00001) and in patients with bcl2+CD71+ (p<.00001 and p=0.02). The patients with discordant in bcl2+CD717 and bcl2-CD71+ showed an intermediate outcome. Noteworthy, patients with bcl2+CD71+ showed a shorter PFS within ZAP-70 negative subgroup (p=0.00009). In multivariate analysis of PFS, age (p=0.005), beta-2 microglobulin (B2 -M) (p=0.003), bcl-2 (p=0.004), CD49d (p=0.001), and ZAP-70 (p<.001) resulted to be significant prognostic factors. The independent prognostic significance of B2 -M (p=0.009) and bcl-2 (p=0.03) was confirmed within ZAP-70 negative patients. Bcl-2 and CD71 can be considered as interesting progression indicators, which should be validated in an independent cohort of patients, to take timely therapeutic decisions in CLL. © 2010 Informa Healthcare USA, Inc.