Cancers (Jun 2019)

Elevated Lactate Dehydrogenase Has Prognostic Relevance in Treatment-Naïve Patients Affected by Chronic Lymphocytic Leukemia with Trisomy 12

  • Francesco Autore,
  • Paolo Strati,
  • Idanna Innocenti,
  • Francesco Corrente,
  • Livio Trentin,
  • Agostino Cortelezzi,
  • Carlo Visco,
  • Marta Coscia,
  • Antonio Cuneo,
  • Alessandro Gozzetti,
  • Francesca Romana Mauro,
  • Anna Maria Frustaci,
  • Massimo Gentile,
  • Fortunato Morabito,
  • Stefano Molica,
  • Paolo Falcucci,
  • Giovanni D’Arena,
  • Roberta Murru,
  • Donatella Vincelli,
  • Dimitar G Efremov,
  • Antonietta Ferretti,
  • Gian Matteo Rigolin,
  • Candida Vitale,
  • Maria Chiara Tisi,
  • Gianluigi Reda,
  • Andrea Visentin,
  • Simona Sica,
  • Robin Foà,
  • Alessandra Ferrajoli,
  • Luca Laurenti

DOI
https://doi.org/10.3390/cancers11070896
Journal volume & issue
Vol. 11, no. 7
p. 896

Abstract

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Chronic Lymphocytic Leukemia (CLL) patients with +12 have been reported to have specific clinical and biologic features. We performed an analysis of the association between demographic; clinical; laboratory; biologic features and outcome in CLL patients with +12 to identify parameters predictive of disease progression; time to treatment; and survival. The study included 487 treatment-naive CLL patients with +12 from 15 academic centers; diagnosed between January 2000 and July 2016; and 816 treatment-naïve patients with absence of Fluorescence In Situ Hybridization (FISH) abnormalities. A cohort of 250 patients with +12 CLL followed at a single US institution was used for external validation. In patients with +12; parameters associated with worse prognosis in the multivariate model were high Lactate DeHydrogenase (LDH) and β-2-microglobulin and unmutated immunoglobulin heavy-chain variable region gene (IGHV). CLL patients with +12 and high LDH levels showed a shorter Progression-Free-Survival (PFS) (30 months vs. 65 months; p < 0.001), Treatment-Free-Survival (TFS) (33 months vs. 69 months; p < 0.001), Overall Survival (OS) (131 months vs. 181 months; p < 0.001) and greater CLL-related mortality (29% vs. 11% at 10 years; p < 0.001) when compared with +12 CLL patients with normal LDH levels. The same differences were observed in the validation cohort. These data suggest that serum LDH levels can predict PFS; TFS; OS and CLL-specific survival in CLL patients with +12.

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