Assessment of the Progression Risk of Chronic Lymphocytic Leukemia

Abstract

Objective: to identify the interconnection of laboratory parameters with different courses of chronic lymphocytic leukemia (CLL) and to develop a comprehensive model for the assessment of the risk of the disease progression. Material and methods. The study included 127 patients with CLL whose laboratory parameters were evaluated (general and biochemical blood tests, β2-microglobulin, thymidinekinase, tissue polypeptide antigen (TPA), immunophenotypic markers, and also NOTCH1 gene mutations). Results. For the prediction of the course of the disease the most informative were such markers as β2-microglobulin, thymidinekinase, ZAP-70, CD38, and TPA. Based on the obtained data, a model of the risk assessment for CLL progression with high sensitivity and specificity was developed. The progressive-free survival (PFS) was evaluated in two groups of the patients of different risk (low and high) assigned to them according to the prognostic model. In the patients from the low-risk group PFS was determined to be 60 months, and in the high-risk group it was equal to 29.4 months. And it was found out that the patients without progression at the time of inclusion in the study with the presence of mutations of the NOTCH1 gene had a shorter PFS in comparison with the patients without mutations, which may indicate a link between the mutations of the NOTCH1 gene and the unfavorable prognosis for the disease progression. Conclusion . The integrated application of the prognostic factors in the form of a CLL progression risk assessment model allows to stratify CLL patients into high and low risk groups and to predict the probability and progression rate at the time of the diagnosis and during the treatment.