Browse > Article
http://dx.doi.org/10.5045/br.2018.53.4.276

Clinicohematological parameters and outcomes in a cohort of chronic lymphocytic leukemia patients with Deletion 17p from Pakistan  

Mahmood, Rafia (Department of Haematology, Armed Forces Institute of Pathology)
Khan, Saleem Ahmed (Department of Haematology, Armed Forces Institute of Pathology)
Altaf, Chaudhry (Department of Haematology, Armed Forces Institute of Pathology)
Malik, Hamid Saeed (Department of Haematology, Armed Forces Institute of Pathology)
Khadim, Muhammad Tahir (Department of Haematology, Armed Forces Institute of Pathology)
Publication Information
BLOOD RESEARCH / v.53, no.4, 2018 , pp. 276-280 More about this Journal
Abstract
Background Chronic lymphocytic leukemia (CLL) exhibits profound heterogeneity in its clinical course. Its clinicohematological and cytogenetic features play a significant role in determining the clinical course and in predicting the treatment response and prognosis. In this context, 17p deletion is known to predict a poor prognosis, as these cases are refractory to conventional therapy. This study aimed to evaluate the clinicohematological characteristics, outcomes, and prognostic factors among CLL patients with and without del 17p in Pakistan. Methods This prospective observational study was conducted at the Department of Haematology, Armed Forces Institute of Pathology (Rawalpindi, Pakistan) between January 2013 and December 2017. Patients were diagnosed based on the International Workshop on Chronic Lymphocytic Leukaemia IWCLL criteria, their clinicohematological parameters were recorded, and cytogenetic analyses were performed. The time from diagnosis to treatment and the 2-year overall survival rate were also evaluated. Results We evaluated 130 CLL cases, including 24 patients (18.5%) with del 17p, who included 18 men (75%) and 6 women (25%). The median age was 68 years. Binet stage C was detected at the presentation in 16 patients (67%). Treatment was administered to 14 patients (70%) at a median interval of 11 months (range, 0-28 mo) after diagnosis. The overall response rate was 64.3%, the median event-free survival was 9 months (range, 1-23 mo), and the 2-year overall survival rate was 65%. Conclusion Del 17p is relatively common in Pakistan, and patients harboring this deletion had poor treatment response and survival outcomes.
Keywords
Chronic lymphocytic leukemia; Fluorescent in situ hybridization; Event-free survival; Overall survival;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Nabhan C, Rosen ST. Chronic lymphocytic leukemia: a clinical review. JAMA 2014;312:2265-76.   DOI
2 Eid OM, Eid MM, Kayed HF, et al. Detection of cytogenetics abnormalities in chronic lymphocytic leukemia using FISH technique and their prognostic impact. Gulf J Oncolog 2014;1:68-75.
3 Teimori H, Ashoori S, Akbari MT, Mojtabavi Naeini M, Hashemzade Chaleshtori M. FISH analysis for del6q21 and del17p13 in B-cell chronic lymphocytic leukemia in Iranians. Iran Red Crescent Med J 2013;15:107-12.   DOI
4 Parker TL, Strout MP. Chronic lymphocytic leukemia: prognostic factors and impact on treatment. Discov Med 2011;11:115-23.
5 Sutton LA, Rosenquist R. Deciphering the molecular landscape in chronic lymphocytic leukemia: time frame of disease evolution. Haematologica 2015;100:7-16.   DOI
6 Gribben JG. How I treat CLL up front. Blood 2010;115:187-97.   DOI
7 Amare PS, Gadage V, Jain H, et al. Clinico-pathological impact of cytogenetic subgroups in B-cell chronic lymphocytic leukemia: experience from India. Indian J Cancer 2013;50:261-7.   DOI
8 Messmer BT, Nour-Omid TS, Ghia E, Sanchez AB, Kipps TJ. Autoantibodies against p53 are associated with chromosome 17p deletions in chronic lymphocytic leukemia. Leuk Res 2011;35:965-7.   DOI
9 Jain N, O'Brien S. Chronic lymphocytic leukemia with deletion 17p: emerging treatment options. Oncology (Williston Park) 2012;26:1067-70.
10 Gribben JG, O'Brien S. Update on therapy of chronic lymphocytic leukemia. J Clin Oncol 2011;29:544-50.
11 Strati P, Keating MJ, O'Brien SM, et al. Outcomes of first-line treatment for chronic lymphocytic leukemia with 17p deletion. Haematologica 2014;99:1350-5.   DOI
12 Dohner H, Stilgenbauer S, Benner A, et al. Genomic aberrations and survival in chronic lymphocytic leukemia. N Engl J Med 2000;343:1910-6.   DOI
13 Schnaiter A, Stilgenbauer S. 17p deletion in chronic lymphocytic leukemia: risk stratification and therapeutic approach. Hematol Oncol Clin North Am 2013;27:289-301.   DOI
14 Gonzalez D, Martinez P, Wade R, et al. Mutational status of the TP53 gene as a predictor of response and survival in patients with chronic lymphocytic leukemia: results from the LRF CLL4 trial. J Clin Oncol 2011;29:2223-9.   DOI
15 Byrd JC, Jones JJ, Woyach JA, Johnson AJ, Flynn JM. Entering the era of targeted therapy for chronic lymphocytic leukemia: impact on the practicing clinician. J Clin Oncol 2014;32:3039-47.   DOI
16 Hallek M. Chronic lymphocytic leukemia: 2013 update on diagnosis, risk stratification and treatment. Am J Hematol 2013;88:803-16.   DOI
17 Delgado J, Espinet B, Oliveira AC, et al. Chronic lymphocytic leukaemia with 17p deletion: a retrospective analysis of prognostic factors and therapy results. Br J Haematol 2012;157:67-74.   DOI
18 Shindiapina P, Brown JR, Danilov AV. A new hope: novel therapeutic approaches to treatment of chronic lymphocytic leukaemia with defects in TP53. Br J Haematol 2014;167:149-61.   DOI
19 Junaid A, Rao PN, Adil MM. Chromosomal study for prognostic grouping in chronic lymphocytic leukemia. J Coll Physicians Surg Pak 2011;21:19-22.
20 Sindelarova L, Michalova K, Zemanova Z, et al. Incidence of chromosomal anomalies detected with FISH and their clinical correlations in B-chronic lymphocytic leukemia. Cancer Genet Cytogenet 2005;160:27-34.   DOI
21 Rozman C, Montserrat E. Chronic lymphocytic leukemia. N Engl J Med 1995;333:1052-7.   DOI
22 Lin K, Sherrington PD, Dennis M, Matrai Z, Cawley JC, Pettitt AR. Relationship between p53 dysfunction, CD38 expression, and IgV(H) mutation in chronic lymphocytic leukemia. Blood 2002;100:1404-9.   DOI