Kamaso Joanna, Puiggros Anna, Salido Marta, Melero Carme, Rodríguez-Rivera María, Gimeno Eva, Martínez Laia, Arenillas Leonor, Calvo Xavier, Román David, Abella Eugènia, Ramos-Campoy Silvia, Lorenzo Marta, Ferrer Ana, Collado Rosa, Moro-García Marco Antonio, Espinet Blanca
Molecular Cytogenetics and Hematological Cytology Laboratories, Pathology Department, Hospital del Mar, 08003 Barcelona, Spain.
Translational Research on Hematological Neoplasms Group, Cancer Research Program, Hospital del Mar Research Institute (HMRI), 08003 Barcelona, Spain.
Cancers (Basel). 2024 Jun 18;16(12):2258. doi: 10.3390/cancers16122258.
Current CLL guidelines recommend a two parallel cultures assessment using TPA and IL2+DSP30 mitogens for complex karyotype (CK) detection. Studies comparing both mitogens for CK identification in the same cohort are lacking. We analyzed the global performance, CK detection, and concordance in the complexity assessment of two cytogenetic cultures from 255 CLL patients. IL2+DSP30 identified more altered karyotypes than TPA (50 vs. 39%, = 0.031). Moreover, in 71% of those abnormal by both, IL2+DSP30 identified more abnormalities and/or abnormal metaphases. CK detection was similar for TPA and IL2+DSP30 (10% vs. 11%). However, 11/33 CKs (33%) were discordant, mainly due to the detection of a normal karyotype or no metaphases in the other culture. Patients requiring treatment within 12 months after sampling (active CLL) displayed significantly more CKs than those showing a stable disease (55% vs. 12%, < 0.001). Disease status did not impact cultures' concordance (κ index: 0.735 and 0.754 for stable and active). Although CK was associated with shorter time to first treatment (TTFT) using both methods, IL2+DSP30 displayed better accuracy than TPA for predicting TTFT (C-index: 0.605 vs. 0.580, respectively). In summary, the analysis of two parallel cultures is the best option to detect CKs in CLL. Nonetheless, IL2+DSP30 could be prioritized above TPA to optimize cytogenetic assessment in clinical practice.
当前慢性淋巴细胞白血病（CLL）指南推荐使用佛波酯（TPA）和白细胞介素2（IL2）+十二烷基磺酸钠（DSP30）有丝分裂原进行两种平行培养评估，以检测复杂核型（CK）。目前尚缺乏在同一队列中比较这两种有丝分裂原用于CK鉴定的研究。我们分析了255例CLL患者两种细胞遗传学培养在整体性能、CK检测及复杂性评估方面的一致性。IL2+DSP30检测出的核型改变比TPA更多（50%对39%，P = 0.031）。此外，在两种方法均检测为异常的病例中，71%的病例IL2+DSP30检测出更多的异常和/或异常中期分裂相。TPA和IL2+DSP30的CK检测率相似（10%对11%）。然而，33例CK中有11例（33%）不一致，主要是因为在另一种培养中检测到正常核型或无中期分裂相。采样后12个月内需要治疗的患者（活动性CLL）显示出的CK明显多于病情稳定的患者（55%对12%，P < 0.001）。疾病状态不影响培养的一致性（稳定和活动性疾病的κ指数分别为0.735和0.754）。尽管使用两种方法CK均与首次治疗时间（TTFT）缩短相关，但在预测TTFT方面，IL2+DSP30比TPA具有更高的准确性（C指数分别为0.605和0.580）。总之，分析两种平行培养是检测CLL中CK的最佳选择。尽管如此，在临床实践中为优化细胞遗传学评估，可优先选择IL2+DSP30而非TPA。
