Haematologica (Jan 2016)

Clinical significance of bax/bcl-2 ratio in chronic lymphocytic leukemia

  • Maria Ilaria Del Principe,
  • Michele Dal Bo,
  • Tamara Bittolo,
  • Francesco Buccisano,
  • Francesca Maria Rossi,
  • Antonella Zucchetto,
  • Davide Rossi,
  • Riccardo Bomben,
  • Luca Maurillo,
  • Mariagiovanna Cefalo,
  • Giovanna De Santis,
  • Adriano Venditti,
  • Gianluca Gaidano,
  • Sergio Amadori,
  • Paolo de Fabritiis,
  • Valter Gattei,
  • Giovanni Del Poeta

DOI
https://doi.org/10.3324/haematol.2015.131854
Journal volume & issue
Vol. 101, no. 1

Abstract

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In chronic lymphocytic leukemia the balance between the pro-apoptotic and anti-apoptotic members of the bcl-2 family is involved in the pathogenesis, chemorefractoriness and clinical outcome. Moreover, the recently proposed anti-bcl-2 molecules, such as ABT-199, have emphasized the potential role of of bcl-2 family proteins in the context of target therapies. We investigated bax/bcl-2 ratio by flow cytometry in 502 patients and identified a cut off of 1.50 to correlate bax/bcl-2 ratio with well-established clinical and biological prognosticators. Bax/bcl-2 was 1.50 or over in 263 patients (52%) with chronic lymphocytic leukemia. Higher bax/bcl-2 was associated with low Rai stage, lymphocyte doubling time over 12 months, beta-2 microglobulin less than 2.2 mg/dL, soluble CD23 less than 70 U/mL and a low risk cytogenetic profile (P