Molecular cytogenetic follow-up of chronic lymphocytic leukemia patients with unfavorable prognosis

Abstract

In this pilot study results of prolonged (up to 74 month) follow-up of 16 CLL patients with del17p13 or del11q22 in the first I-FISH analysis have been presented. It was shown that the presences of del17p13 or del11q22 as well as the rate of the aberrant cells having those abnormalities are significant for the prognosis and clinical course of CLL. The high rate (more than 70 %) of cells with 17p13 deletion means very unfavorable cytogenetic marker and indicates the short survival. On the other hand the low rate of cells with 17p13 deletion may predict disease progression but in case of effective treatment there are no effects on the patient’s survival. The high rate (more than 70 %) of cells with del11q22 indicates the early requiring for treatment. It was revealed the frequency of cells with marker aberrations may change in the same patient including decreasing to the control level as result of treatment and without it too. The frequency of aberrant cells decreases significantly after the finishing of appropriated treatments program and usually returns to its previous level in case of relapse and/or progression of disease. The subclones’ ratio between different marker abnormalities could vary during treatment and after its ending. It’s also possible the occurrence of new leukemic cells subclones. Taking in consideration the wide range of clinical CLL course and the possibility of the clonal evolution, the FISH-analysis should be as integral part of clinical practice both during the CLL staging and the next patient’s follow-up.

Keywords

• chronic lymphocytic leukemia (cll)
• interphase fluorescence in situ hybridization (i-fish)
• del17p13
• del11q22
• follow-up