Department of Internal Medicine-Hematology/Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic.
Eur J Haematol. 2011 Aug;87(2):130-7. doi: 10.1111/j.1600-0609.2011.01639.x.
The impact of modern prognostic markers on clinical course of chronic lymphocytic leukaemia (CLL) in everyday practice has been not yet well defined, especially in large series of patients. Therefore, the goal of this study was to assess the influence of conventional as well as modern prognostic factors on overall survival (OS) and time to therapy (TTT) of patients with CLL.
We retrospectively analysed data of all patients consecutively entered into the databases of five large academic centres in the Czech Republic. The total of 1300 patients was included in the analysis.
Through the use of uniparametric analysis, it was determined that gender, clinical stage Rai II-IV, unmutated IgVH status, deletion 17p (for both 5% and 20% cut-off), deletion 11q, ZAP-70 positivity and high expression of CD38 had significant negative influence on OS. TTT was significantly influenced by gender, Rai stage, IgVH status, deletion 11q, deletion 17p, deletion 13q and CD38 expression. Multiparametric analysis revealed that OS was significantly influenced by gender, age, IgVH status and deletion 17p. If only patients who died of CLL were included, gender, age, Rai stage, IgVH status and deletion 17p had significant influence on OS. Based on our results, the examination of biological prognostic markers can give an insight into the possible disease evolution in daily clinical practice. Biological prognostic markers are, however, not ready (maybe except deletion 17p in younger patients) to be used for guidance of therapy at least outside of clinical trials.
现代预后标志物对慢性淋巴细胞白血病（CLL）临床病程的影响在日常实践中尚未得到很好的定义，尤其是在大量患者的系列中。因此，本研究的目的是评估常规和现代预后因素对 CLL 患者总生存（OS）和治疗时间（TTT）的影响。
我们回顾性分析了捷克共和国五所大型学术中心数据库中连续纳入的所有患者的数据。共纳入 1300 例患者进行分析。
通过使用单参数分析，确定性别、临床分期 Rai II-IV、未突变的 IgVH 状态、缺失 17p（无论是 5%还是 20%的截断值）、缺失 11q、ZAP-70 阳性和高表达 CD38 对 OS 有显著的负面影响。TTT 显著受性别、Rai 分期、IgVH 状态、缺失 11q、缺失 17p、缺失 13q 和 CD38 表达的影响。多参数分析显示 OS 显著受性别、年龄、IgVH 状态和缺失 17p 的影响。如果只纳入死于 CLL 的患者，性别、年龄、Rai 分期、IgVH 状态和缺失 17p 对 OS 有显著影响。基于我们的结果，检查生物学预后标志物可以深入了解日常临床实践中疾病的可能演变。然而，生物学预后标志物尚未准备好（也许除了年轻患者的缺失 17p 外），至少在临床试验之外，不能用于指导治疗。
