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Jain N, Wierda WG, O'Brien S. Chronic lymphocytic leukaemia. Lancet 2024; 404:694-706. [PMID: 39068951 DOI: 10.1016/s0140-6736(24)00595-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 02/22/2024] [Accepted: 03/21/2024] [Indexed: 07/30/2024]
Abstract
The last decade has seen remarkable progress in our understanding of disease biology of chronic lymphocytic leukaemia (CLL) and the development of novel targeted therapies. Randomised clinical trials have reported improved progression-free survival and overall survival with targeted therapies compared with chemoimmunotherapy, and thereby the role of chemoimmunotherapy in todays' era for treatment of CLL is limited. Bruton tyrosine kinase (BTK) inhibitors, BCL2 inhibitors, and CD20 monoclonal antibodies have been established as appropriate therapy options for patients with CLL, both as the first-line treatment and in the treatment of relapsed or refractory CLL. Several ongoing phase 3 trials are exploring different combinations of targeted therapies, and the results of these trials might change the treatment framework in first-line treatment of CLL. Non-covalent BTK inhibitors, chimeric antigen receptor T-cell therapy, and other therapeutic strategies are being investigated in relapsed CLL. Some of the therapies used in relapsed CLL, such as non-covalent BTK inhibitors, are now being pursued in earlier lines of therapy, including first-line treatment of CLL.
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Affiliation(s)
- Nitin Jain
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - William G Wierda
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Susan O'Brien
- Division of Hematology/Oncology, Department of Medicine, Chao Family Comprehensive Cancer Center, University of California Irvine Medical Center, Orange, CA, USA.
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2
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Liu P, Wang K, Li J, Ogasawara MA, Xia Z, Wierda WG, Keating MJ, Li Y, Huang P. Global miRNA profiling reveals key molecules that contribute to different chronic lymphocytic leukemia incidences in Asian and Western populations. Haematologica 2024; 109:479-492. [PMID: 37646669 PMCID: PMC10828772 DOI: 10.3324/haematol.2023.283181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 08/14/2023] [Indexed: 09/01/2023] Open
Abstract
It has been known for decades that the incidence of chronic lymphocytic leukemia (CLL) is significantly lower in Asia than in Western countries, but the reason responsible for this difference still remains a major knowledge gap. Using GeneChip® miRNA array to analyze the global microRNA expression in B lymphocytes from Asian and Western CLL patients and healthy individuals, we have identified microRNA with CLL-promoting or suppressive functions that are differentially expressed in Asian and Western individuals. In particular, miR-4485 is upregulated in CLL patients of both ethnic groups, and its expression is significantly lower in Asian healthy individuals. Genetic silencing of miR-4485 in CLL cells suppresses leukemia cell growth, whereas ectopic expression of miR-4485 promotes cell proliferation. Mechanistically, miR-4485 exerts its CLL-promoting activity by inhibiting the expression of TGR5 and activating the ERK1/2 pathway. In contrast, miR-138, miR-181a, miR- 181c, miR-181d, and miR-363 with tumor-suppressive function are highly expressed in Asian healthy individuals. Our study suggests that differential expression of several important microRNA with pro- or anti-CLL functions in Asian and Western B lymphocytes likely contributes to the difference in CLL incidence between the two ethnic groups, and that miR-4485 and its downstream molecule TGR5 could be potential therapeutic targets.
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Affiliation(s)
- Panpan Liu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China; Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou.
| | - Kefeng Wang
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510000, China; Department of Thoracic Surgery, Sun Yat-sen Memorial Hospital,Sun Yat-sen University, Guangzhou
| | - Jianan Li
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China; Department of Hematologic Oncology, Sun Yat-sen University Cancer Center, Guangzhou
| | - Marcia A Ogasawara
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030
| | - Zhongjun Xia
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China; Department of Hematologic Oncology, Sun Yat-sen University Cancer Center, Guangzhou
| | - William G Wierda
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030
| | - Michael J Keating
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030
| | - Yiqing Li
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510000, China; Department of Hematology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, P. R. China.
| | - Peng Huang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou.
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Broccia G, Carter J, Ozsin-Ozler C, De Matteis S, Cocco P. Epidemiology of Chronic Lymphocytic Leukemia in Sardinia, Italy (1974-2003). Exp Hematol 2023; 125-126:37-44. [PMID: 37567460 DOI: 10.1016/j.exphem.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/06/2023] [Accepted: 08/07/2023] [Indexed: 08/13/2023]
Abstract
Several reports have described a worldwide increasing incidence of chronic lymphocytic leukemia (CLL) dating back seven to eight decades. Although genetic susceptibility would be an implausible explanation, the determinants of this upward trend and its spatial coordinates are poorly understood. We explored CLL incidence in Sardinia, Italy, using a validated database including the 1700 CLL cases diagnosed during 1974-2003. We applied Bayesian methods to map the CLL probability by administrative unit and Poisson regression analysis to investigate socioeconomic and environmental determinants adjusting by possible confounders. The standardized (Standard European population) incidence rate for the Sardinian population over the study period was 5.1 per 100,000 (95% confidence interval [CI] 4.9-5.3), increased annually by 5.8% (95% CI 5.7-6.0) consistently by sex and age, and was more noticeable in urban areas. Five administrative units exceeded the 95% posterior probability of an elevated CLL incidence: these were rural areas spread over the regional territory, not suggestive of spatial clustering. The Poisson regression analysis showed that the risk was elevated in urban areas (RR = 1.11, 95% CI 1.05-1.17), among residents ≥ 30 km from the nearest hospital (RR = 1.09, 95% CI 1.06-1.12), and with the local prevalence of cork harvesting (RR = 1.62, 95% CI 1.12-2.34). Our results suggest that better access to health care facilities and improvements in diagnostic efficacy might have generated the observed upward trend in CLL incidence, along with contributing environmental factors.
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Affiliation(s)
- Giorgio Broccia
- Department of Haematology and Bone Marrow Transplants, Hospital A. Businco, Cagliari, Sardinia, Italy
| | | | - Cansu Ozsin-Ozler
- Department of Paediatric Dentistry, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Sara De Matteis
- Department of Medical Sciences and Public Health, University of Cagliari, Monserrato, Italy
| | - Pierluigi Cocco
- Centre for Occupational and Environmental Health, Division of Public Health, Health Services Research & Primary Care, University of Manchester, Manchester, UK.
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Tang C, Shen Y, Soosapilla A, Mulligan SP. Monoclonal B-cell Lymphocytosis - a review of diagnostic criteria, biology, natural history, and clinical management. Leuk Lymphoma 2022; 63:2795-2806. [PMID: 35767361 DOI: 10.1080/10428194.2022.2092857] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Since first described almost two decades ago, there has been significant evolution in our definition and understanding of the biology and implications of monoclonal B-cell lymphocytosis (MBL). This review provides an overview of the definition, classification, biology, and natural history of MBL, mainly focused on the dominant CLL-like phenotype form of MBL. The increasingly recognized implications of MBL with respect to immune dysfunction are discussed, particularly in view of the COVID-19 pandemic, along with management recommendations for MBL in the clinic.
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Affiliation(s)
- Catherine Tang
- Department of Haematology and Flow Cytometry, Laverty Pathology, Sydney, Australia.,Department of Haematology, Gosford Hospital, Gosford, Australia.,School of Medicine and Public Health, The University of Newcastle, Newcastle, Australia
| | - Yandong Shen
- Department of Haematology, Royal North Shore Hospital, St Leonards, Sydney, Australia.,Kolling Institute, University of Sydney, St Leonards, Sydney, Australia
| | - Asha Soosapilla
- Department of Haematology and Flow Cytometry, Laverty Pathology, Sydney, Australia
| | - Stephen P Mulligan
- Department of Haematology and Flow Cytometry, Laverty Pathology, Sydney, Australia.,Department of Haematology, Royal North Shore Hospital, St Leonards, Sydney, Australia.,Kolling Institute, University of Sydney, St Leonards, Sydney, Australia
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5
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Yi JH, Lee GW, Lee JH, Yoo KH, Jung CW, Kim DS, Lee JO, Eom HS, Byun JM, Koh Y, Yoon SS, Kim JS, Kong JH, Yhim HY, Yang DH, Yoon DH, Lim DH, Lee WS, Shin HJ. Multicenter retrospective analysis of patients with chronic lymphocytic leukemia in Korea. Blood Res 2021; 56:243-251. [PMID: 34801988 PMCID: PMC8721453 DOI: 10.5045/br.2021.2021102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 07/12/2021] [Accepted: 08/25/2021] [Indexed: 12/01/2022] Open
Abstract
Background Chronic lymphocytic leukemia (CLL) is the most common type of adult leukemia in Western countries but is rare in the East Asian countries. Due to its rarity and the lack of feasible novel agents and laboratory prognostic tools, there are limited data on the clinical outcomes of this disease in Asia. To clarify the current treatment status, we performed a multicenter retrospective analysis of patients with CLL in Korea. Methods The medical records of 192 eligible patients between 2008 and 2019 were reviewed for clinical characteristics, treatment courses, and outcomes. The first-line treatment regimens of the patients included in this analysis were as follows fludarabine/cyclophosphamide/rituximab (FCR) (N=117, 52.7%), obinutuzumab plus chlorambucil (GC) (N=30, 13.5%), and chlorambucil monotherapy (N=24, 10.8%). Results The median progression-free survival (PFS) was 55.6 months, and the average 2-year PFS rate was 80.3%. PFS was not significantly different between the patients receiving FCR and those receiving GC; however, chlorambucil treatment was associated with significantly inferior PFS (P<0.001). The median overall survival was 136.3 months, and the average 5- and 10-year OS rates were 82.0% and 57.4%, respectively. Conclusion This is one of the largest studies involving Korean patients with CLL. Although the patients had been treated with less favored treatment regimens, the outcomes were not different from those reported in Western studies.
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Affiliation(s)
- Jun Ho Yi
- Division of Hematology-Oncology, Department of Medicine, Chung-Ang University Hospital, Seoul, Korea
| | - Gyeong-Won Lee
- Division of Hematology-Oncology, Department of Internal Medicine, Institute of Health Science, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Ji Hyun Lee
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
| | - Kwai Han Yoo
- Division of Hematology-Oncology, Gachon University College of Medicine, Incheon, Korea
| | - Chul Won Jung
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dae Sik Kim
- Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea
| | - Jeong-Ok Lee
- Division of Hematology-Oncology, Seoul National University Bundang Hospital, Seongnam, Korea
| | | | - Ja Min Byun
- Division of Hematology-Oncology, Seoul National University Hospital, Seoul, Korea
| | - Youngil Koh
- Division of Hematology-Oncology, Seoul National University Hospital, Seoul, Korea
| | - Sung Soo Yoon
- Division of Hematology-Oncology, Seoul National University Hospital, Seoul, Korea
| | - Jin Seok Kim
- Division of Hematology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jee Hyun Kong
- Division of Hematology-Oncology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Ho-Young Yhim
- Department of Internal Medicine, Jeonbuk National University Medical School, Jeonju, Korea
| | - Deok-Hwan Yang
- Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, Gwangju, Korea
| | - Dok Hyun Yoon
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Do Hyoung Lim
- Division of Hematology-Oncology, Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Korea
| | - Won-Sik Lee
- Inje University Busan Paik Hospital, Busan, Korea
| | - Ho-Jin Shin
- Division of Hematology-Oncology, Department of Internal Medicine, School of Medicine, Medical Research Institute, Pusan National University Hospital, Busan, Korea
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7
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Management of Chronic Lymphocytic Leukemia in Less-Resourced Countries. ACTA ACUST UNITED AC 2021; 27:314-319. [PMID: 34398558 DOI: 10.1097/ppo.0000000000000533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
ABSTRACT Despite the practice-changing advances achieved in the prognostic stratification and treatment of chronic lymphocytic leukemia (CLL), a large fraction of the world population resides in countries where access to many of these advances remains unavailable or subject to severe constraints. Although some of these countries display incidence rates of CLL that are lower than those of developed Western countries, a large number of patients are expected to be diagnosed with CLL in these regions every year. In this article, we review issues regarding management of CLL in some less-resourced countries, with a focus on the evidence basis for epidemiological and clinical information on this disease, the availability of diagnostic and therapeutic resources, and participation in clinical trials. Going forward, challenges that still need to be addressed include the development of unified countrywide registries, guidelines for management applicable to each country, wider availability of prognostic tools, access to new drugs, and policies that ensure these drugs are affordable to all patients worldwide.
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8
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Radivoyevitch T. Parameter perturbations in a post-treatment chronic myeloid leukemia model capture the essence of pre-diagnosis A-bomb survivor mysteries. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2021; 60:41-47. [PMID: 33125593 PMCID: PMC7597434 DOI: 10.1007/s00411-020-00879-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 10/12/2020] [Indexed: 06/11/2023]
Abstract
A model of post-diagnosis chronic myeloid leukemia (CML) dynamics across treatment cessations is applied here to pre-diagnosis scenarios of A-bomb survivors. The main result is that perturbing two parameters of a two-state simplification of this model captures the essence of two A-bomb survivor mysteries: (1) in those exposed to > 1 Sv in Hiroshima, four of six female onsets arose as a cluster in 1969-1974, well after 5-10-year latencies expected and observed in two of six female- and nine of ten male cases (about one background case was expected in this high-dose cohort); and (2) no Nagasaki adult cases exposed to > 0.2 Sv were observed though about nine were expected (~ 1.5 background + ~ 7.5 radiation-induced). Overall, it is concluded that: (1) whole-body radiation co-creates malignant and benign BCR-ABL clones; (2) benign clones are more likely to act as anti-CML vaccines in females than in males; (3) the Hong Kong flu of 1968 (and H3N2 seasonal flu thereafter) exhausted anti-CML immunity, thereby releasing radiation-induced clones latent in high-dose Hiroshima females; and (4) benign cells of 1-2 are CD4+ as human T-cell leukemia-lymphoma virus-1 endemic to Nagasaki but not Hiroshima expands numbers of such cells. The next goal is to see if these conclusions can be substantiated using banked A-bomb survivor blood samples.
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MESH Headings
- Atomic Bomb Survivors
- CD4-Positive T-Lymphocytes/immunology
- Female
- Humans
- Influenza A Virus, H3N2 Subtype
- Influenza, Human/immunology
- Japan/epidemiology
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnosis
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/immunology
- Leukemia, Radiation-Induced/diagnosis
- Leukemia, Radiation-Induced/immunology
- Male
- Models, Biological
- Neoplastic Stem Cells/immunology
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Affiliation(s)
- Tomas Radivoyevitch
- Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, JJN3-01, 9500 Euclid Ave, Cleveland, OH, 44195, USA.
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Yang S, Varghese AM, Sood N, Chiattone C, Akinola NO, Huang X, Gale RP. Ethnic and geographic diversity of chronic lymphocytic leukaemia. Leukemia 2020; 35:433-439. [PMID: 33077870 DOI: 10.1038/s41375-020-01057-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 09/02/2020] [Accepted: 10/05/2020] [Indexed: 12/16/2022]
Abstract
East Asians, Asian Indians and Amerindians have a five to ten-fold lower age-adjusted incidence rate (AAIR) of chronic lymphocytic leukaemia (CLL) compared with persons of predominately European descent. The data we review suggest a genetic rather than environmental basis for this discordance. All these populations arose from a common African Black ancestor but different clades have different admixture with archaic hominins including Neanderthals, Denisovans and Homo erectus, which may explain different CLL incidences. There are also some differences in clinical laboratory and molecular co-variates of CLL between these populations. Because the true age-adjusted incidence rate in African Blacks is unknown it is not possible to determine whether modern Europeans acquired susceptibility to CLL or the other populations lost susceptibility and/or developed resistance to developing CLL. We also found other B-cell lymphomas and T- and NK-cell cancers had different incidences in the populations we studied. These data provide clues to determining the cause(s) of CLL.
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Affiliation(s)
- Shenmiao Yang
- Peking University Peoples Hospital; Peking University Institute of Hematology, Beijing, China
| | - Abraham M Varghese
- Little Flower Hospital and Research Centre, Kerala, India.,St James University Hospital, Leeds, UK
| | - Nitin Sood
- Clinical Haematology and Stem Cell Transplant, Medanta-Medicity, Gurgaon, India
| | - Carlos Chiattone
- Department of Hematology and Oncology, Santa Casa Medical School, Sao Paulo, Brazil
| | - Norah O Akinola
- Department of Haematology and Immunology, Obafemi Awolowo University and Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | - Xiaojun Huang
- Peking University Peoples Hospital; Peking University Institute of Hematology, Beijing, China
| | - Robert Peter Gale
- Haematology Research Centre, Department of Immunology and Inflammation, Imperial College London, London, UK.
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Shuai W, Lin P, Strati P, Patel KP, Routbort MJ, Hu S, Wei P, Khoury JD, You MJ, Loghavi S, Tang Z, Fang H, Thakral B, Medeiros LJ, Wang W. Clinicopathological characterization of chronic lymphocytic leukemia with MYD88 mutations: L265P and non-L265P mutations are associated with different features. Blood Cancer J 2020; 10:86. [PMID: 32848129 PMCID: PMC7450076 DOI: 10.1038/s41408-020-00351-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 07/29/2020] [Accepted: 08/05/2020] [Indexed: 02/06/2023] Open
Abstract
MYD88 mutations in chronic lymphocytic leukemia (CLL) are not well characterized. Earlier reports yielded conflicting results in terms of clinicopathologic presentation and prognostic impact of MYD88 mutations in CLL patients. In addition, the morphological and immunophenotypic features of CLL cases carrying MYD88 mutations have not been explored. Finally, the clinical or biologic implications of the canonical L265P MYD88 mutation vs. mutations in other sites of MYD88 within the context of CLL are also unknown. In this study, a cohort of 1779 CLL patients underwent mutational analysis, and 56 (3.1%) cases were found to have MYD88 mutations, including 38 with L265P mutations (designated here as group A) and 18 with non-L265P mutations (group B). Cases with wild type MYD88 were included as controls. There was no morphological difference in cases with and without MYD88 mutations. Immunophenotypically, cases with mutated MYD88 (both groups A and B) more frequently had an atypical immunophenotype when compared to wild type cases. Group A patients were younger and were associated with variable favorable prognostic factors, including less elevated β2-microglobulin level, negative CD38 and ZAP70, higher frequency of mutated IGHV and isolated del(13q14.3), and lower frequency of del(11q22.3) and mutations of NOTCH1 and SF3B1. In contrast, group B patients were more similar to CLL patients with wild type MYD88. There was no difference in time to first treatment when comparing MYD88-mutated vs. wild type CLL patients before and after stratification according to IGHV mutation status. In summary, MYD88 mutations are uncommon in CLL and cases with L265P mutation have distinctive clinical, immunophenotypic, cytogenetic, and molecular features. There is no significant impact of MYD88 mutations on time to first treatment in CLL.
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Affiliation(s)
- Wen Shuai
- Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Pei Lin
- Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Paolo Strati
- Departments of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Keyur P Patel
- Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Mark J Routbort
- Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Shimin Hu
- Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Peng Wei
- Departments of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Joseph D Khoury
- Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - M James You
- Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Sanam Loghavi
- Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Zhenya Tang
- Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Hong Fang
- Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Beenu Thakral
- Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - L Jeffrey Medeiros
- Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Wei Wang
- Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.
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Meacham PJ, Williams AM, Strawderman M, Baran AM, Archibald WJ, Wallace DS, Tschernia NP, Burack WR, Barr PM, Zent CS. Additional B-cell malignancies in patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL). Leuk Lymphoma 2020; 61:1636-1644. [PMID: 32175786 DOI: 10.1080/10428194.2020.1737690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Family and migration studies suggest a genetic risk of developing chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL). We hypothesized that CLL patients have an increased risk of additional clonally unrelated B-cell malignancies. To test this, we studied 467 CLL patients (2743 person-years (PYs)) at a single institution over 17 years. The incidence rate (IR) of any additional B-cell lymphoid malignancy was 10.9 per 1000 PYs (n = 30, 6.4%). Eighteen (4%) patients had a clonally unrelated B-cell malignancy (IR = 6.6 per 1000 PYs). Standardized incidence ratios (SIRs) were used to compare the incidence of additional clonally unrelated B-cell malignancies in CLL patients to the age- and sex-matched expected rates in the USA generated from the Surveillance, Epidemiology, and End Results (SEER) database. For the subset of 13 patients having data for comparison in the SEER database, the SIR was 5.41 (95% CI = 2.9, 9.3) which is supportive of our hypothesis.
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Affiliation(s)
| | | | | | | | | | | | | | - Walter Richard Burack
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY, USA
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12
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Huang SJ, Chan J, Bruyère H, Allan LL, Gerrie AS, Toze CL. Chronic lymphocytic leukemia patients with HLA-B27 referred for allogeneic hematopoietic stem cell transplantation do not have worse outcomes: Results of a population-based case series analysis in British Columbia, Canada. Leuk Res 2019; 84:106193. [PMID: 31325731 DOI: 10.1016/j.leukres.2019.106193] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 07/11/2019] [Accepted: 07/14/2019] [Indexed: 12/22/2022]
Abstract
Human leukocyte antigen B27 (HLA-B27), associated with spondyloarthritis, was suggested to be protective against chronic lymphocytic leukemia (CLL). It is hypothesized that HLA-B27 patients may have worse outcome in part related to their other comorbidities. OBJECTIVES We sought to compare the clinical characteristics and outcomes of CLL and small lymphocytic lymphoma (SLL) patients referred for allogeneic hematopoietic stem cell transplantation (allo-HSCT) based on their HLA-B27 status. METHODS This retrospective population-based case series analyzed CLL/SLL patients who were HLA-typed for potential allo-HSCT in British Columbia, Canada. RESULTS of 279 CLL/SLL patients referred for potential allo-HSCT, 34 patients were HLA-B27 positive. For HLA-B27 patients, median age at CLL diagnosis was 53.5 years (range, 27-67) and 71% were male. Seven patients had 11q deletion and nine patients had 17p deletion detected prior to first CLL therapy or at relapse. Eleven HLA-B27 patients received allo-HSCT. Two patients developed acute myeloid leukemia. One patient with ankylosing spondylitis had Richter's transformation prior to any CLL therapy. Spondyloarthritis-related disorders were diagnosed in 12 HLA-B27 patients but there was no temporal correlation with development of CLL. Overall survival (OS) and treatment-free survival (TFS) were not significantly different between HLA-B27 patients with or without spondyloarthritis-related disorders. There were no significant differences in clinical characteristics at CLL diagnosis or OS/TFS between HLA-B27 positive and negative patients referred for allo-HSCT. CONCLUSIONS HLA-B27 positivity does not appear to influence outcome for CLL/SLL patients referred for allo-HSCT. Further studies are needed to evaluate the clinical significance of HLA-B27 in a general CLL population.
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Affiliation(s)
- Steven J Huang
- Division of Hematology and Leukemia/BMT Program of British Columbia, Vancouver General Hospital, University of British Columbia, Canada
| | - Jonathan Chan
- Division of Rheumatology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Helene Bruyère
- Division of Pathology and Laboratory Medicine, Cytogenetics Laboratory, Vancouver General Hospital, University of British Columbia, Canada
| | - Lenka L Allan
- Division of Pathology and Laboratory Medicine, Immunology Laboratory, Vancouver General Hospital, University of British Columbia, Canada
| | - Alina S Gerrie
- Division of Hematology and Leukemia/BMT Program of British Columbia, Vancouver General Hospital, University of British Columbia, Canada; British Columbia Cancer Agency, University of British Columbia, Vancouver, British Columbia, Canada
| | - Cynthia L Toze
- Division of Hematology and Leukemia/BMT Program of British Columbia, Vancouver General Hospital, University of British Columbia, Canada; British Columbia Cancer Agency, University of British Columbia, Vancouver, British Columbia, Canada.
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13
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Yang S, Gale RP, Shi H, Liu Y, Lai Y, Lu J, Huang X. Is there an epidemic of chronic lymphocytic leukaemia (CLL) in China? Leuk Res 2018; 73:16-20. [PMID: 30176386 DOI: 10.1016/j.leukres.2018.08.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 08/01/2018] [Accepted: 08/05/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND Chronic lymphocytic leukaemia (CLL) is 10- to 20-fold less common in Asians (including Han Chinese) compared with persons of predominately European descent. Why is unknown but seems predominately genetic. We observed an increasing frequency of new cases of CLL at our Haematology Centre beginning 2011 and wondered why. OBJECTIVE Determine the cause(s) for this increased frequency. METHOD We interrogated the context of CLL diagnosis in 483 consecutive subjects seen at the Institute of Haematology of a large referral hospital in Beijing. 3 cohorts were considered based on why a CBC was done to establish the CLL diagnosis: (1) a CBC-testing situation unrelated to a health condition such as a routine annual health exam or application for employment or medical insurance (termed routine CBC); (2) an unrelated medical condition such as a cold, influenza, heart disease etc. (termed CBC for other disorders); and (3) signs and/or symptoms consistent with CLL such as lymph-adenopathy, hepato- or splenomegaly, fatigue, B-symptoms etc. (termed CBC for possible CLL). RESULTS Data regarding context of CLL diagnosis were available for 389 subjects (81%). Proportions of subjects in the 3 cohorts were 44% (95% confidence interval [CI]; 39, 49%), 24% (20, 28%) and 32% (28, 37%). The proportion of subjects whose evaluation of CLL was prompted by an abnormal CBC not for possible CLL (cohorts 1 and 2) increased over the surveillance interval (r = 0.164; P = 0.001) as did median age at diagnosis (r = 0.207; P < 0.001). Age at diagnosis was correlated with probability of CLL being suspected because of an abnormal routine CBC (r = 0.249; P < 0.001); 42% (32, 53%) amongst subjects ≤50 years versus 86% (75, 92%; P < 0.001) among those >70 years. Consistent with this, older subjects were diagnosed at Rai stage-0 with asymptomatic disease compared with younger subjects (P < 0.001). CONCLUSION Our data suggest much of the increased frequency of CLL at our centre and likely elsewhere in China predominately reflects ascertainment bias. Other variables may also operate.
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Affiliation(s)
- Shenmiao Yang
- Peking University Peoples Hospital, Peking University Institute of Hematology, China
| | - Robert Peter Gale
- Haematology Research Centre, Division of Experimental Medicine, Department of Medicine, Imperial College London, London, SW7 2AZ, UK.
| | - Hongxia Shi
- Peking University Peoples Hospital, Peking University Institute of Hematology, China
| | - Yanrong Liu
- Peking University Peoples Hospital, Peking University Institute of Hematology, China
| | - Yueyun Lai
- Peking University Peoples Hospital, Peking University Institute of Hematology, China
| | - Jin Lu
- Peking University Peoples Hospital, Peking University Institute of Hematology, China
| | - Xiaojun Huang
- Peking University Peoples Hospital, Peking University Institute of Hematology, China; Peking-Tsinghua Center for Life Sciences, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China.
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14
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Qin Y, Song Y, Shen Z, Du X, Ji W, Hsu W, Zhu J, Shi Y. Safety and efficacy of obinutuzumab in Chinese patients with B-cell lymphomas: a secondary analysis of the GERSHWIN trial. Cancer Commun (Lond) 2018; 38:31. [PMID: 29843792 PMCID: PMC5993131 DOI: 10.1186/s40880-018-0300-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 03/28/2018] [Indexed: 01/01/2023] Open
Abstract
Background Patients with relapsed/refractory B-cell lymphomas have limited treatment options. GERSHWIN is an open-label, single-arm, phase Ib study of obinutuzumab monotherapy in Chinese patients with histologically documented CD20+ relapsed/refractory chronic lymphocytic leukemia (CLL), diffuse large B-cell lymphoma (DLBCL), or follicular lymphoma (FL). The primary outcome measure of pharmacokinetics has been previously reported. We now present data on the secondary endpoint measures (e.g., safety, and efficacy and pharmacodynamics). Methods Patients received 1000 mg obinutuzumab intravenously on days 1, 8, and 15 of cycle 1 (CLL patients; first dose split over 2 days), and on day 1 of cycles 2–8. Each cycle lasted for 21 days; the treatment period was 24 weeks. All subjects receiving at least one dose of obinutuzumab were included in the analysis of safety, efficacy, as well as pharmacodynamics. Results A total of 48 patients (> 18 years of age) were enrolled (CLL: 12; DLBCL: 23; FL: 13). The subjects received a median of two lines of anticancer treatment prior to the enrollment. Thirty-five patients (72.9%) had at least one adverse event (AE). The most frequent AE was infusion-related reactions (15 patients; 31.3%), followed by pyrexia (11 patients; 22.9%). Treatment-related AEs were reported in 28 patients (58.3%), and included one death (interstitial lung disease). End-of-treatment (EoT) response rate was 33.3%. Best overall response rate was 47.9%. Most CLL patients achieved a partial response at EoT (58.3%). CD19+ depletion occurred in 75.0% of the patients with CLL, and all patients with FL and DLBCL. Conclusions The safety and efficacy of obinutuzumab monotherapy in Chinese patients with B-cell lymphomas were similar to that observed in previous studies in non-Chinese patients; no new safety signals were observed. Clinical trial registration ID NCT01680991 Electronic supplementary material The online version of this article (10.1186/s40880-018-0300-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yan Qin
- Department of Medical Oncology, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, P. R. China
| | - Yuqin Song
- Department of Lymphoma, Beijing Cancer Hospital, Peking University, Beijing, 100142, P. R. China
| | - Zhixiang Shen
- Department of Hematology, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, 200025, P. R. China
| | - Xin Du
- Department of Hematology, Guangdong General Hospital/Guangdong Academy of Medical Sciences, Guangzhou, 510030, Guangdong, P. R. China
| | - Wei Ji
- Clinical Science, Shanghai Roche Pharmaceuticals Ltd, Shanghai, 201203, P. R. China
| | - Wanling Hsu
- Statistics, Roche (China) Holding Ltd, Shanghai, 201203, P. R. China
| | - Jun Zhu
- Department of Lymphoma, Beijing Cancer Hospital, Peking University, Beijing, 100142, P. R. China
| | - Yuankai Shi
- Department of Medical Oncology, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, P. R. China.
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15
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Huang X, Qiu L, Jin J, Zhou D, Chen X, Hou M, Hu J, Hu Y, Ke X, Li J, Liang Y, Liu T, Lv Y, Ren H, Sun A, Wang J, Zhao C, Salman M, Sun S, Howes A, Wang J, Wu P, Li J. Ibrutinib versus rituximab in relapsed or refractory chronic lymphocytic leukemia or small lymphocytic lymphoma: a randomized, open-label phase 3 study. Cancer Med 2018. [PMID: 29533000 PMCID: PMC5911578 DOI: 10.1002/cam4.1337] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
In the Asia‐Pacific region, treatment options are limited for patients with relapsed/refractory chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL). Rituximab is widely used in this setting when purine analog‐based therapies are not appropriate. We evaluated the efficacy and safety of ibrutinib compared with rituximab in a randomized, open‐label phase 3 study in predominantly Asian patients with relapsed/refractory CLL/SLL. Patients (N = 160) were randomly assigned 2:1 to receive 420 mg ibrutinib (n = 106) until disease progression (PD) or unacceptable toxicity or up to six cycles of rituximab (n = 54). The primary endpoint was investigator‐assessed progression‐free survival (PFS); key secondary endpoints were overall response rate (ORR), overall survival (OS), and safety. Rituximab‐treated patients could crossover to receive ibrutinib after confirmed PD. At data cutoff, median treatment duration was 16.4 months for ibrutinib and 4.6 months for rituximab. Ibrutinib significantly improved PFS (hazard ratio [HR] = 0.180, 95% confidence interval [CI]: 0.105–0.308). ORR was significantly higher (P < 0.0001) with ibrutinib (53.8%) than with rituximab (7.4%). At a median follow‐up of 17.8 months, ibrutinib improved OS compared with rituximab (HR = 0.446; 95% CI: 0.221–0.900; P = 0.0206). Overall incidence of adverse events (AEs) was similar between treatments and was not exposure‐adjusted. With ibrutinib, most common AEs were diarrhea and platelet count decreased; with rituximab, most common AEs were neutrophil count decreased and platelet count decreased. Grade ≥3 AEs were reported in 82.7% of ibrutinib‐treated patients and 59.6% of rituximab‐treated patients. Ibrutinib improved PFS, ORR, and OS compared with rituximab and displayed a manageable safety profile in Asian patients with relapsed/refractory CLL/SLL.
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Affiliation(s)
| | - Lugui Qiu
- Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences, Tianjin, China
| | - Jie Jin
- The First Affiliated Hospital, Zhejiang University College of Medicine, Zhejiang, China
| | - Daobin Zhou
- Peking Union Medical College Hospital, Beijing, China
| | | | - Ming Hou
- Qilu Hospital of Shandong University, Jinan, China
| | - Jianda Hu
- Fujian Medical University Union Hospital, Fuzhou, China
| | - Yu Hu
- Wuhan Union Hospital, Wuhan, China
| | - Xiaoyan Ke
- Peking University Third Hospital, Beijing, China
| | | | | | - Ting Liu
- West China Hospital, Chengdu, China
| | - Yue Lv
- Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Hanyun Ren
- Peking Union Medical College Hospital, Beijing, China
| | - Aining Sun
- The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Jianmin Wang
- Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Chunting Zhao
- The Affiliated Hospital of Qingdao University Medical College, Qingdao, China
| | | | - Steven Sun
- Janssen Research & Development, Raritan, New Jersey
| | - Angela Howes
- Janssen Research & Development, High Wycombe, UK
| | - Jingzhao Wang
- Janssen China Research & Development Center, Beijing, China
| | - Peng Wu
- Janssen China Research & Development Center, Beijing, China
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16
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Marinelli M, Ilari C, Xia Y, Del Giudice I, Cafforio L, Della Starza I, Raponi S, Mariglia P, Bonina S, Yu Z, Yang W, Qiu L, Chan T, Piciocchi A, Kwong YL, Tse E, Li J, Guarini A, Xu W, Foà R. Immunoglobulin gene rearrangements in Chinese and Italian patients with chronic lymphocytic leukemia. Oncotarget 2018; 7:20520-31. [PMID: 26943037 PMCID: PMC4991472 DOI: 10.18632/oncotarget.7819] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 02/16/2016] [Indexed: 01/12/2023] Open
Abstract
Chronic lymphocytic leukemia (CLL) is the most common type of leukemia in the Western world, whereas in Asia the incidence is about 10 times lower. The basis for this ethnic and geographic variation is currently unknown. The aim of this study was to characterize IGHVDJ rearrangements and stereotype of the HCDR3 region in a series of 623 Chinese CLL, in order to identify possible differences in immunoglobulin gene usage and their potential pathogenetic implications. Chinese CLL were compared to 789 Italian CLL. Chinese patients showed a higher proportion of mutated IGHV and a more frequent usage of IGHV3-7, IGHV3-74, IGHV4-39 and IGHV4-59 genes. A significantly lower usage of IGHV1-69 and IGHV1-2 was documented, with comparable IGHV3-21 frequency (3% Chinese vs 3.8% Italian CLL). The proportion of known stereotyped receptors was significantly lower in Chinese (19.7%) than in Italian CLL (25.8%), despite a significantly higher frequency of subset #8 (p= 0.0001). Moreover, new paired clusters were identified among Chinese cases. Overall, these data support a potential different antigenic exposure between Eastern and Western CLL.
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Affiliation(s)
- Marilisa Marinelli
- Department of Cellular Biotechnologies and Hematology, "Sapienza" University, Rome, Italy
| | - Caterina Ilari
- Department of Cellular Biotechnologies and Hematology, "Sapienza" University, Rome, Italy
| | - Yi Xia
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Ilaria Del Giudice
- Department of Cellular Biotechnologies and Hematology, "Sapienza" University, Rome, Italy
| | - Luciana Cafforio
- Department of Cellular Biotechnologies and Hematology, "Sapienza" University, Rome, Italy
| | - Irene Della Starza
- Department of Cellular Biotechnologies and Hematology, "Sapienza" University, Rome, Italy
| | - Sara Raponi
- Department of Cellular Biotechnologies and Hematology, "Sapienza" University, Rome, Italy
| | - Paola Mariglia
- Department of Cellular Biotechnologies and Hematology, "Sapienza" University, Rome, Italy
| | - Silvia Bonina
- Department of Cellular Biotechnologies and Hematology, "Sapienza" University, Rome, Italy
| | - Zhen Yu
- Department of Lymphoma & Myeloma Institute of Hematology, CAMS & PUMC, Tianjin, China
| | - Wenjuan Yang
- Department of Lymphoma & Myeloma Institute of Hematology, CAMS & PUMC, Tianjin, China
| | - Lugui Qiu
- Department of Lymphoma & Myeloma Institute of Hematology, CAMS & PUMC, Tianjin, China
| | - Thomas Chan
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | | | - Yok-Lam Kwong
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - Eric Tse
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - Jianyong Li
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Anna Guarini
- Department of Cellular Biotechnologies and Hematology, "Sapienza" University, Rome, Italy
| | - Wei Xu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Robin Foà
- Department of Cellular Biotechnologies and Hematology, "Sapienza" University, Rome, Italy
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17
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Chan TSY, Lee YS, Giudice ID, Marinelli M, Ilari C, Cafforio L, Guarini A, Tan D, Phipps C, Goh YT, Hwang W, Goh AZK, Siu LLP, Wu S, Ha CY, Lin SY, Kwok CH, Lau CK, Wong KF, Foà R, Kwong YL, Tse E. Clinicopathological features and outcome of chronic lymphocytic leukaemia in Chinese patients. Oncotarget 2017; 8:25455-25468. [PMID: 28424415 PMCID: PMC5421943 DOI: 10.18632/oncotarget.16037] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 02/13/2017] [Indexed: 12/27/2022] Open
Abstract
Chronic lymphocytic leukaemia (CLL) is uncommon in Chinese population and its biology, genetics and treatment outcome in Chinese patients have not been comprehensively investigated. In this study, we studied the clinicopathological features and outcome of 212 Chinese patients with newly diagnosed CLL in Hong Kong and Singapore. The median age at diagnosis was 64 years. The majority of patients presented with early-stage disease (Binet stage A, 56.1%). Del(13)(q14) was the most frequent abnormality (41.7%) detected by fluorescence in situ hybridization (FISH) analysis. Del(17p) and TP53 gene mutations were detected in 7.8% and 8.2% of patients, respectively. MYD88 mutations were found at a higher frequency (11.5%) than expected. CLL with unmutated variable region of the immunoglobulin heavy chain genes (IGHV) occurred in only 31.2% of cases, and was associated with advanced-stage disease (p <0.01) and adverse FISH abnormalities (p<0.01). With a median follow-up of 39 months, the median overall survival (OS) was 108 months. The presence of del(17p) or TP53 mutations was associated with a significantly shorter time to first treatment and an inferior OS (p <0.01). Unmutated IGHV was also associated with a significantly shorter time to treatment (p <0.01). Among patients who required treatment, the median OS and progression-free survival (PFS) were 107 and 23 months, respectively. The presence of del(17p) was associated with a significantly inferior OS and PFS (p <0.01). In summary, Chinese CLL patients had similar genetic aberrations at diagnosis compared with those of Western populations. FISH abnormalities are major factors affecting outcome.
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Affiliation(s)
- Thomas Sau-Yan Chan
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China
| | - Yuh-Shan Lee
- Department of Haematology, Singapore General Hospital, Outram, Singapore
| | - Ilaria Del Giudice
- Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy
| | - Marilisa Marinelli
- Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy
| | - Caterina Ilari
- Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy
| | - Luciana Cafforio
- Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy
| | - Anna Guarini
- Department of Molecular Medicine, Sapienza University, Rome, Italy
| | - Daryl Tan
- Department of Haematology, Singapore General Hospital, Outram, Singapore
| | - Colin Phipps
- Department of Haematology, Singapore General Hospital, Outram, Singapore
| | - Yeow-Tee Goh
- Department of Haematology, Singapore General Hospital, Outram, Singapore
| | - William Hwang
- Department of Haematology, Singapore General Hospital, Outram, Singapore
| | - Allan Zhi-Kai Goh
- Department of Haematology, Singapore General Hospital, Outram, Singapore
| | | | - Saliangi Wu
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong, China
| | - Chun-Yin Ha
- Department of Medicine, Tuen Mun Hospital, Hong Kong, China
| | - Shek-Ying Lin
- Department of Medicine, United Christian Hospital, Hong Kong, China
| | - Chi-Hang Kwok
- Department of Medicine, Princess Margaret Hospital, Hong Kong, China
| | - Chi-Kuen Lau
- Department of Medicine, Tseung Kwan O Hospital, Hong Kong, China
| | - Kit-Fai Wong
- Department of Pathology, Queen Elizabeth Hospital, Hong Kong, China
| | - Robin Foà
- Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy
| | - Yok-Lam Kwong
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China
| | - Eric Tse
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China
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18
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Zhai J, Qin Y, Zhu J, Song Y, Shen Z, Du X, Jamois C, Brewster M, Shi Y, Shi J. Pharmacokinetics of obinutuzumab in Chinese patients with B-cell lymphomas. Br J Clin Pharmacol 2017; 83:1446-1456. [PMID: 28072473 PMCID: PMC5465338 DOI: 10.1111/bcp.13232] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 12/14/2016] [Accepted: 01/04/2017] [Indexed: 11/29/2022] Open
Abstract
Aim The Phase Ib GERSHWIN study (NCT01680991) assessed the pharmacokinetic (PK) profile of obinutuzumab following multiple intravenous (i.v.) doses to Chinese patients with B‐cell lymphomas, and compared findings with previous obinutuzumab PK studies in mainly Caucasian (non‐Chinese) patients. Methods GERSHWIN was an open‐label, single‐arm intervention study. Patients aged >18 years with CD20+ relapsed/refractory chronic lymphocytic leukaemia (CLL), diffuse large B‐cell lymphoma (DLBCL) or follicular lymphoma (FL) were enrolled from four centres in China. The treatment period was 24 weeks; patients received obinutuzumab 1000 mg i.v. on Days (D)1, 8 and 15 of Cycle (C)1 (CLL patients: first infusion split over 2 days) and on D1 of C2–8 (all cycles: 21 days). PK parameters were estimated using non‐compartmental analysis (NCA), and a population PK analysis was used to determine whether observed GERSHWIN PK data were in accordance with previous obinutuzumab PK studies in non‐Chinese patients. Results The PK analysis population included 48 patients: 28 patients completed all treatment cycles. NCA showed a similar PK profile in Chinese patients with FL, DLBCL and CLL. Steady‐state concentrations of obinutuzumab appeared to be reached at the start of C2 irrespective of histology. There was no apparent relationship between body weight and systemic exposure. Most PK profiles observed in GERSHWIN lay within the 90% prediction interval of simulated profiles. Conclusions Obinutuzumab exposure was comparable in CLL, DLBCL and FL patients. NCA and population PK analysis indicate that PK characteristics of Chinese patients with B‐cell lymphomas are similar to those in non‐Chinese patients.
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Affiliation(s)
- John Zhai
- Roche Innovation Center Shanghai, Shanghai, China
| | - Yan Qin
- Department of Medical Oncology, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College (PUMC), Beijing, China
| | - Jun Zhu
- Department of Lymphoma, Beijing Cancer Hospital, Peking University, Beijing, China
| | - Yuqin Song
- Department of Lymphoma, Beijing Cancer Hospital, Peking University, Beijing, China
| | - Zhixiang Shen
- Department of Hematology, Ruijin Homainlyspital, Shanghai Jiaotong University, Shanghai, China
| | - Xin Du
- Department of Hematology, Guangdong General Hospital/Guandong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | | | | | - Yuankai Shi
- Department of Medical Oncology, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College (PUMC), Beijing, China
| | - Jun Shi
- Roche Innovation Center Shanghai, Shanghai, China
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19
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Li H, Yi SH, Xiong WJ, Liu HM, Lyu R, Wang TY, Liu W, Zhong SZ, Yu Z, Zou DH, Xu Y, An G, Li ZJ, Qiu LG. Chronic Lymphocytic Leukemia Prognostic Index: A New Integrated Scoring System to Predict the Time to First Treatment in Chinese Patients with Chronic Lymphocytic Leukemia. Chin Med J (Engl) 2017; 130:135-142. [PMID: 28091403 PMCID: PMC5282668 DOI: 10.4103/0366-6999.197978] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The established clinical staging systems (Rai/Binet) of chronic lymphocytic leukemia (CLL) cannot accurately predict the appropriate treatment of patients in the earlier stages. In the past two decades, several prognostic factors have been identified to predict the outcome of patients with CLL, but only a few studies investigated more markers together. To predict the time to first treatment (TTFT) in patients of early stages, we evaluated the prognostic role of conventional markers as well as cytogenetic abnormalities and combined them together in a new prognostic scoring system, the CLL prognostic index (CLL-PI). METHODS Taking advantage of a population of 406 untreated Chinese patients with CLL at early and advanced stage of disease, we identified the strongest prognostic markers of TTFT and, subsequently, in a cohort of 173 patients who had complete data for all 3 variables, we integrated the data of traditional staging system, cytogenetic aberrations, and mutational status of immunoglobulin heavy chain variable region (IGHV) in CLL-PI. The median follow-up time was 45 months and the end point was TTFT. RESULTS The median TTFT was 38 months and the 5-year overall survival was 80%. According to univariate analysis, patients of advanced Rai stages (P < 0.001) or with 11q- (P = 0.002), 17p- (P < 0.001), unmutated IGHV (P < 0.001), negative 13q- (P = 0.007) and elevated lactate dehydrogenase levels (P = 0.001) tended to have a significantly shorter TTFT. And subsequently, based on multivariate Cox regression analysis, three independent factors for TTFT were identified: advanced clinical stage (P = 0.002), 17p- (P = 0.050) and unmutated IGHV (P = 0.049). Applying weighted grading of these independent factors, a CLL-PI was constructed based on regression parameters, which could categorize four different risk groups (low risk [score 0], intermediate low [score 1], intermediate high [score 2] and high risk [score 3-6]) with significantly different TTFT (median TTFT of not reached (NR), 65.0 months, 36.0 months and 19.0 months, respectively, P < 0.001). CONCLUSIONS This study developed a weighted, integrated CLL-PI prognostic system of CLL patients which combines the critical genetic prognostic markers with traditional clinical stage. This novel modified PI system could be used to discriminate among groups and may help predict the TTFT and prognosis of patients with CLL.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- China
- Chromosome Aberrations
- Chromosomes, Human, Pair 17/genetics
- DNA Mutational Analysis
- Female
- Humans
- Immunoglobulin Heavy Chains/genetics
- Immunoglobulin Heavy Chains/metabolism
- In Situ Hybridization, Fluorescence
- Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/metabolism
- Male
- Middle Aged
- Mutation
- Prognosis
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Affiliation(s)
- Heng Li
- Department of Lymphoma and Myeloma, State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300041, China
| | - Shu-Hua Yi
- Department of Lymphoma and Myeloma, State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300041, China
| | - Wen-Jie Xiong
- Department of Lymphoma and Myeloma, State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300041, China
| | - Hui-Min Liu
- Department of Lymphoma and Myeloma, State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300041, China
| | - Rui Lyu
- Department of Lymphoma and Myeloma, State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300041, China
| | - Ting-Yu Wang
- Department of Lymphoma and Myeloma, State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300041, China
| | - Wei Liu
- Department of Lymphoma and Myeloma, State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300041, China
| | - Shi-Zhen Zhong
- Department of Lymphoma and Myeloma, State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300041, China
| | - Zhen Yu
- Department of Lymphoma and Myeloma, State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300041, China
| | - De-Hui Zou
- Department of Lymphoma and Myeloma, State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300041, China
| | - Yan Xu
- Department of Lymphoma and Myeloma, State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300041, China
| | - Gang An
- Department of Lymphoma and Myeloma, State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300041, China
| | - Zeng-Jun Li
- Department of Lymphoma and Myeloma, State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300041, China
| | - Lu-Gui Qiu
- Department of Lymphoma and Myeloma, State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300041, China
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20
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Detection of non-CLL-like monoclonal B cell lymphocytosis increases dramatically in the very elderly, while detection of CLL-like populations varies by race: findings in a multiethnic population-based cohort of elderly women. Ann Hematol 2016; 95:1695-704. [DOI: 10.1007/s00277-016-2760-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Accepted: 07/08/2016] [Indexed: 10/21/2022]
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21
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Vasylyev A, Loginov A, Molostvova V, Rebrov B, Pereira MHS, Melo CWA, Makarova J, Pashanov ED, Mysnik A. Prevalence and cumulative 5-year incidence of chronic lymphocytic leukemia in the adult population in the Russian Federation and Ukraine: Data from the LEUKOSPECT study. Hematology 2016; 22:16-24. [DOI: 10.1080/10245332.2016.1201630] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Affiliation(s)
| | | | | | - Boris Rebrov
- Luhansk Regional Clinical Hospital, Luhansk, Ukraine
| | | | | | - Janina Makarova
- Russia Medical Department, GlaxoSmithKline, Moscow, Russian Federation
| | | | - Andriy Mysnik
- Country Medical Department, GlaxoSmithKline, Kyiv, Ukraine
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22
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Ionizing radiation exposures in treatments of solid neoplasms are not associated with subsequent increased risks of chronic lymphocytic leukemia. Leuk Res 2016; 43:9-12. [DOI: 10.1016/j.leukres.2016.02.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Revised: 02/14/2016] [Accepted: 02/17/2016] [Indexed: 01/30/2023]
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23
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Bassig BA, Au WY, Mang O, Ngan R, Morton LM, Ip DKM, Hu W, Zheng T, Seow WJ, Xu J, Lan Q, Rothman N. Subtype-specific incidence rates of lymphoid malignancies in Hong Kong compared to the United States, 2001-2010. Cancer Epidemiol 2016; 42:15-23. [PMID: 26991956 DOI: 10.1016/j.canep.2016.02.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 01/20/2016] [Accepted: 02/21/2016] [Indexed: 11/19/2022]
Abstract
Clinical studies of lymphoid malignancies (LMs) have suggested that the descriptive patterns of LMs differ in East Asia compared to Western populations. However, there are very limited available data on population-based, subtype-specific incidence rates of LMs in the East Asian population, particularly in Chinese. Using data from the Hong Kong (HK) Cancer Registry and United States (U.S.) SEER Program, we calculated and compared age-adjusted incidence rates of LM subtypes in HK to those in Whites and Asians living in the U.S. Overall and sex-specific rates were calculated for the period 2001-2010. The incidence of most subtypes was low in the HK population, with rates <1 case per 100,000 for all subtypes except for diffuse large B-cell lymphoma (3.26/100,000) and plasma cell neoplasms (1.99/100,000). Age-adjusted incidence rates of all evaluated B-cell subtypes were significantly higher in U.S. Whites compared to HK, with standardized rate ratios (SRRs) ranging from 1.6 (Burkitt lymphoma) to 9.1 (chronic lymphocytic leukemia/small lymphocytic lymphoma). Rates in U.S. Asians were generally intermediate to those in U.S. Whites and HK. Conversely, rates of extranodal NK/T-cell lymphoma were significantly lower in both U.S. Whites (SRR=0.2) and U.S. Asians (SRR=0.5) compared to HK. Our data provide new insight into the subtype-specific patterns of LMs in the Chinese population, and suggest the need for etiological studies of LMs in the East Asian population to elucidate the factors responsible for these differences in the geographic incidence patterns.
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Affiliation(s)
- Bryan A Bassig
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD, USA.
| | - Wing-Yan Au
- Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong
| | - Oscar Mang
- Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong
| | - Roger Ngan
- Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong
| | - Lindsay M Morton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD, USA
| | - Dennis K M Ip
- Division of Community Medicine and Public Health Practice, School of Public Health, The University of Hong Kong, Hong Kong
| | - Wei Hu
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD, USA
| | - Tongzhang Zheng
- Department of Epidemiology, Brown University, Providence, RI, USA
| | - Wei Jie Seow
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD, USA
| | - Jun Xu
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Qing Lan
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD, USA
| | - Nathaniel Rothman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD, USA
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Lee SJ, Tien HF, Park HJ, Kim JA, Lee DS. Gradual increase of chronic lymphocytic leukemia incidence in Korea, 1999-2010: comparison to plasma cell myeloma. Leuk Lymphoma 2015; 57:585-9. [PMID: 26133722 DOI: 10.3109/10428194.2015.1068307] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Chronic lymphocytic leukemia (CLL) and plasma cell myeloma (PCM) have markedly higher incidences in Western countries compared with Asian countries. To track the change of incidence in Korea, we investigated the 12-year incidence and compared findings with national cancer databases in Taiwan and the United States (US). The age-standardized incidence rates (ASRs) of CLL and PCM in Korea during 1999-2010 were 0.13/100,000 and 1.23/100,000. The annual percentage change (APC) in the incidence rates were 4.17% for CLL and 4.68% for PCM. These increasing trends were similar findings to Taiwan. In the US, the ASRs of CLL and PCM were 3.21/100 000 and 3.97/100,000. The APC of CLL and PCM incidence rate were 0.68% and 0.50%. The incidence rates of CLL in Korea gradually increased during the study period, while those of PCM showed a steeper ascent. In contrast, the incidence rates of CLL and PCM in the US appear to be stable.
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Affiliation(s)
- Seung Jun Lee
- a Department of Laboratory Medicine , Seoul National University College of Medicine , Seoul , Republic of Korea
| | - Hwei-Fang Tien
- b Division of Hematology, Department of Internal Medicine , National Taiwan University Hospital , Taipei , Taiwan
| | - Hyeon Jin Park
- c Cancer for Pediatric Oncology, National Cancer Center , Goyang , Republic of Korea
| | - Jung-Ah Kim
- a Department of Laboratory Medicine , Seoul National University College of Medicine , Seoul , Republic of Korea
| | - Dong Soon Lee
- a Department of Laboratory Medicine , Seoul National University College of Medicine , Seoul , Republic of Korea.,d Cancer Research Institute, Seoul National University College of Medicine , Seoul , Republic of Korea
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25
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Incidence of chronic lymphocytic leukemia and monoclonal B-cell lymphocytosis in Calgary, Alberta, Canada. Leuk Res 2015; 39:429-34. [PMID: 25703352 DOI: 10.1016/j.leukres.2015.01.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Revised: 01/20/2015] [Accepted: 01/29/2015] [Indexed: 01/17/2023]
Abstract
This study provides an update on the incidence of chronic lymphocytic leukemia (CLL) and monoclonal B-cell lymphocytosis (MBL) in a major Canadian city using the 2008 World Health Organization (WHO) diagnostic criteria. Incidence calculations were performed using data from a centralized flow cytometry laboratory servicing southern Alberta, Canada. The age-standardized incidence of 4.01 cases of CLL per 100,000 person-years is nearly half the rate previously reported in Canada. Compared to previous criteria based on absolute lymphocyte count rather than absolute B-cell count, utilizing the 2008 WHO criteria resulted in a 47.6% decline in CLL incidence (8.42 cases per 100,000 using 1996 criteria). As a consequence, MBL rates are 64% higher. In contrast to 1996 criteria showing a peak CLL incidence between ages 70-74, age-specific incidence rates show a continuous increase with advancing age using the 2008 guidelines. We also report a higher male to female ratio of CLL than previous Canadian reports (1.80:1). CLL incidence in southern Alberta is lower than rates recently reported in the United States using the same criteria. This difference may be due in part to the low median age and the lower proportion of persons of Caucasian European ancestry present in our study population.
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The mystery of chronic lymphocytic leukemia (CLL): Why is it absent in Asians and what does this tell us about etiology, pathogenesis and biology? Blood Rev 2014; 29:205-13. [PMID: 25541495 DOI: 10.1016/j.blre.2014.12.001] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Revised: 12/01/2014] [Accepted: 12/09/2014] [Indexed: 11/23/2022]
Abstract
Chronic lymphocytic leukemia/small lymphocytic lymphoma is common in persons of predominately European descent but rare in Asians. Why is unknown but is likely genetically-determined. Environmental factors may also operate but are likely to be less important. When CLL occurs in Asians it has different features than CLL in persons of predominately European descent. The reason(s) for this is also not understood. We reviewed data on CLL in Asians (mostly Han Chinese but also other ethnic groups) and compared these data with those from persons of predominately European descent with CLL. CLL incidence was about 5-10-fold less in Asians. Asians with CLL are younger, have atypical morphologic and immunologic features, an increased proportion of IGHV mutations and rearrangements and briefer freedom-from-progression than persons of predominately European descent with CLL. These observations provide clues to the etiology and biology of CLL. But the mystery continues; more research is needed.
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Abstract
Chronic lymphocytic leukemia (CLL) displays remarkable ethnic predisposition for whites, with relative sparing of African-American and Asian populations. In addition, CLL displays among the highest familial predispositions of all hematologic malignancies, yet the genetic basis for these differences is not clearly defined. The highly polymorphic HLA genes of the major histocompatibility complex play a central role in immune surveillance and confer risk for autoimmune and infectious diseases and several different cancers, the role for which in the development of CLL has not been extensively investigated. The National Marrow Donor Program/Be The Match has collected HLA typing from CLL patients in need of allogeneic hematopoietic stem cell transplant and has recruited millions of volunteers to potentially donate hematopoietic stem cells. HLA genotypes for 3491 US white, 397 African-American, and 90 Hispanic CLL patients were compared with 50 000 controls per population from the donor registry. We identified several HLA alleles associated with CLL susceptibility in each population, reconfirming predisposing roles of HLA-A*02:01 and HLA-DRB4*01:01 in whites. Associations for haplotype DRB4*01:01∼DRB1*07:01∼DQB1*03:03 were replicated across all 3 populations. These findings provide a comprehensive assessment of the role of HLA in the development of severe CLL.
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28
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Slager SL, Zent CS. Genetic risk of chronic lymphocytic leukemia: a tale of two cities. Leuk Lymphoma 2013; 55:735-6. [PMID: 24015842 DOI: 10.3109/10428194.2013.840889] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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