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Immunoglobulin heavy chain (IGH@) translocations negatively impact treatment-free survival for chronic lymphocytic leukemia patients who have an isolated deletion 13q abnormality.

Abstract
Immunoglobulin heavy chain translocations (t(IGH@)) are suggested to portend a poor prognosis in chronic lymphocytic leukemia (CLL). To determine the clinical significance of a t(IGH@) on CLL-specific cytogenetic abnormalities, we analyzed the outcomes of 142 CLL patients referred for fluorescence in situ hybridization (FISH) analysis with our standard FISH panel, which includes testing for a t(IGH@). Whereas patients with unfavorable (deletion 17p, deletion 11q) and intermediate (trisomy 12, normal FISH) cytogenetics with concomitant t(IGH@) had similar median treatment-free survival (TFS) as those without a t(IGH@), patients with deletion 13q (del13q) and a t(IGH@) had significantly worse TFS than those without a t(IGH@): median TFS 4.7 versus 8.0 years, P = 0.03 (hazard ratio 4.21, 95% confidence interval 1.06-16.69 y, P = 0.04 in multivariate analysis after adjusting for age, sex, Rai stage, and white blood cell count). The presence of a t(IGH@) further stratified patients with del13q into two prognostic entities, whereby outcomes of those with coexistent del13q and a t(IGH@) were similar to outcomes of those with high risk cytogenetics. Knowledge of the t(IGH@) status in CLL is therefore of clinical importance, as del13q patients with concomitant t(IGH@) may not retain the previously expected favorable outcome.
AuthorsAlina S Gerrie, Helene Bruyere, Mary Joyce Chan, Chinmay B Dalal, Khaled M Ramadan, Steven J T Huang, Cynthia L Toze, Tanya L Gillan
JournalCancer genetics (Cancer Genet) Vol. 205 Issue 10 Pg. 523-7 (Oct 2012) ISSN: 2210-7762 [Print] United States
PMID22939229 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
CopyrightCopyright © 2012 Elsevier Inc. All rights reserved.
Chemical References
  • Immunoglobulin Heavy Chains
  • Vidarabine
  • fludarabine
Topics
  • Adult
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Cytogenetics
  • Disease-Free Survival
  • Female
  • Humans
  • Immunoglobulin Heavy Chains (genetics)
  • Immunophenotyping
  • In Situ Hybridization, Fluorescence
  • Leukemia, Lymphocytic, Chronic, B-Cell (genetics, immunology, mortality)
  • Male
  • Middle Aged
  • Prognosis
  • Time Factors
  • Translocation, Genetic
  • Vidarabine (analogs & derivatives, therapeutic use)

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