In a nutshell
This study examined the impact of abnormalities in a specific group of genes (called IGHV) for chronic lymphocytic leukemia (CLL). Researchers reported poorer outcomes for patients without IGHV gene mutations.
Some background
CLL is cancer of the blood and bone marrow. CLL affects B cells, which originate in the bone marrow and are responsible for making antibodies to fight infection. In CLL, B cells grow in an uncontrolled manner and accumulate in the bone marrow and blood, where they crowd out healthy blood cells.
CLL usually progresses slowly. However, certain genetic changes due to CLL can affect the prognosis. Identifying these abnormalities is important for appropriate treatment selection. One genetic abnormality has been found on immunoglobulins. These are antibodies produced by B cells. Early studies have shown that abnormalities (mutations) of immunoglobiuln heavy chain (IGHV) genes affect prognosis. More studies are needed to examine this link.
Methods & findings
The aim of this study was to examine the link between IGHV gene mutations and CLL prognosis.
84 patients with CLL were included in this study. Most patients had early-stage CLL. Blood tests measured genetic mutations of IGHV genes. Patients were followed for at least 1 year (and up to 25 years).
38 patients (45.2%) had normal (unmutated) IGHV genes. The remaining patients had at least one mutation on a IGHV gene. Unmutated IGHV genes were significantly associated with advanced stage and disease progression.
Survival was significantly worse for patients with unmutated IGHV genes, regardless of disease stage. Average overall survival (time from treatment until death from any cause) was 95 months. In contrast, average survival for patients whose tumors had mutated IGHV genes was 293 months.
The bottom line
Researchers concluded that CLL patients with unmutated IGHV genes had poorer outcomes compared to patients with IGHV mutations.
Published By :
Blood
Date :
Sep 15, 1999
