Three Prognostic Risk Groups

[Guest guest]

A scoring system based on the expression of six surface molecules

allows the identification of three prognostic risk groups in B-cell

chronic lymphocytic leukemia.

Antonella Zucchetto, Riccardo Bomben, Michele Dal Bo, Paolo Sonego,

Paola Nanni, Maurizio Rupolo, Pietro Bulian, Luigino Dal Maso,

Giovanni Del Poeta, Ilaria Del Principe, Massimo Degan, and

Valter Gattei

J Cell Physiol, December 5, 2005; . Abstract

Clinical and Experimental Hematology Research Unit, Centro di

Riferimento Oncologico, I.R.C.C.S., Aviano (PN), Italy.

We have previously identified 12 surface antigens whose differential

expression represented the signature of B-cell chronic lymphocytic

leukemia (B-CLL) subsets with different prognosis. In the present

study, expression data for these antigens, as determined in 137 B-CLL

cases, all with survivals, were utilized to devise a comprehensive

immunophenotypic scoring system of prognostic relevance for B-CLL

patients. In particular, univariate z score was employed to identify

the markers with greater prognostic impact, while maximally selected

log-rank statistics were chosen to define the optimal cut-off points

capable to split patients into two groups with different survivals. A

weighted immunophenotypic scoring system was developed by integrating

results from these analyses. Six antigens were selected: three

positive prognosticators (CD62L, CD54, CD49c) and three negative

prognosticators (CD49d, CD38, CD79b), with cut-off values ranging

from 30% to 50% of positive cells. By weighing the expression of each

marker according to its statistical power, a complete scoring system,

with point values comprised between 0 (complete absence of phenotypic

conditions associated with good prognosis) and 9 (all the phenotypic

conditions associated with good prognosis fulfilled), allowed to

split the whole set of B-CLL patients, into three distinctive

prognostic groups (P = 4.78 x 10(-11)) with high- (score 0-3),

intermediate- (score 4-6), and low- (score 7-9) risk of death. The

three risk groups showed different distribution of cases as for Rai's

stages, IgV(H) mutations, and ZAP-70 expression. The proposed

immunophenotypic scoring system may be an additional useful tool in

routine diagnostic/prognostic procedures for B-CLL. J.Cell.Physiol.

© 2005 Wiley-Liss, Inc.

PMID: 16331666