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Chronic Lymphocytic Leukemia with Mutated IGHV4-34 Receptors: Shared and Distinct Immunogenetic Features and Clinical Outcomes

A. Xochelli, P. Baliakas, I. Kavakiotis, A. Agathangelidis, LA. Sutton, E. Minga, S. Ntoufa, E. Tausch, XJ. Yan, T. Shanafelt, K. Plevova, M. Boudjogra, D. Rossi, Z. Davis, A. Navarro, Y. Sandberg, FJ. Vojdeman, L. Scarfo, N. Stavroyianni, A....

. 2017 ; 23 (17) : 5292-5301. [pub] 20170523

Jazyk angličtina Země Spojené státy americké

Typ dokumentu časopisecké články

Perzistentní odkaz   https://www.medvik.cz/link/bmc18024995

Purpose: We sought to investigate whether B cell receptor immunoglobulin (BcR IG) stereotypy is associated with particular clinicobiological features among chronic lymphocytic leukemia (CLL) patients expressing mutated BcR IG (M-CLL) encoded by the IGHV4-34 gene, and also ascertain whether these associations could refine prognostication.Experimental Design: In a series of 19,907 CLL cases with available immunogenetic information, we identified 339 IGHV4-34-expressing cases assigned to one of the four largest stereotyped M-CLL subsets, namely subsets #4, #16, #29 and #201, and investigated in detail their clinicobiological characteristics and disease outcomes.Results: We identified shared and subset-specific patterns of somatic hypermutation (SHM) among patients assigned to these subsets. The greatest similarity was observed between subsets #4 and #16, both including IgG-switched cases (IgG-CLL). In contrast, the least similarity was detected between subsets #16 and #201, the latter concerning IgM/D-expressing CLL. Significant differences between subsets also involved disease stage at diagnosis and the presence of specific genomic aberrations. IgG subsets #4 and #16 emerged as particularly indolent with a significantly (P < 0.05) longer time-to-first-treatment (TTFT; median TTFT: not yet reached) compared with the IgM/D subsets #29 and #201 (median TTFT: 11 and 12 years, respectively).Conclusions: Our findings support the notion that BcR IG stereotypy further refines prognostication in CLL, superseding the immunogenetic distinction based solely on SHM load. In addition, the observed distinct genetic aberration landscapes and clinical heterogeneity suggest that not all M-CLL cases are equal, prompting further research into the underlying biological background with the ultimate aim of tailored patient management. Clin Cancer Res; 23(17); 5292-301. ©2017 AACR.

1st Department of Propaedeutic Medicine University of Athens Athens Greece

2nd Medical Department University Hospital Schleswig Holstein Campus Kiel Kiel Germany

Central European Institute of Technology Masaryk University Brno Czech Republic

Clinic for Hematology Clinical Center Belgrade Serbia Medical faculty University of Belgrade Belgrade Serbia

Department 1 of Internal Medicine and Center of Integrated Oncology University Hospital Cologne Cologne Germany

Department of Haemato Oncology Belfast City Hospital Belfast United Kingdom

Department of Haematology Royal Bournemouth Hospital Bournemouth United Kingdom

Department of Hematology Department of Medicine Mayo Clinic Rochester Minnesota

Department of Hematology Hopital Pitie Salpetriere and University Pierre et Marie Curie Paris France

Department of Hematology Rigshospitalet Copenhagen Denmark

Department of Immunology Erasmus MC University Medical Center Rotterdam Rotterdam the Netherlands

Department of Immunology Genetics and Pathology Science for Life Laboratory Uppsala University Uppsala Sweden

Department of Immunology Genetics and Pathology Science for Life Laboratory Uppsala University Uppsala Sweden Department of Molecular Medicine and Surgery Karolinska Institutet Stockholm Sweden

Department of Immunology Mayo Clinic Rochester Minnesota United States

Department of informatics Aristotle University of Thessaloniki Thessaloniki Greece

Department of Internal Medicine 3 Ulm University Ulm Germany

Department of Medicine Hematology and Clinical Immunology Branch Padua University School of Medicine Padova Italy

Department of Medicine Solna Clinical Epidemiology Unit Karolinska Institutet Stockholm Sweden

Division of Experimental Oncology and Department of Onco Hematology IRCCS San Raffaele Scientific Institute Milan Italy

Division of Experimental Oncology and Department of Onco Hematology IRCCS San Raffaele Scientific Institute Milan Italy Università Vita Salute San Raffaele and IRCCS Istituto Scientifico San Raffaele Milan Italy

Division of Haematology Department of Translational Medicine University of Eastern Piedmont Novara Italy

Feinstein Institute for Medical Research Northwell Health Manhasset New York

Hematology Department and HCT Unit G Papanicolaou Hospital Thessaloniki Greece

Hematology Department Nikea General Hospital Piraeus Greece

IMGT® the international ImMunoGeneTics information system® Université de Montpellier LIGM Institut de Génétique Humaine IGH UPR CNRS 1142 Montpellier France

Institut d'Investigacions Biomèdiques August Pi i Sunyer Hospital Clínic University of Barcelona Barcelona Spain

Institute of Applied Biosciences CERTH Thessaloniki Greece

Institute of Applied Biosciences CERTH Thessaloniki Greece Department of Immunology Genetics and Pathology Science for Life Laboratory Uppsala University Uppsala Sweden

Institute of Applied Biosciences CERTH Thessaloniki Greece Department of Immunology Genetics and Pathology Science for Life Laboratory Uppsala University Uppsala Sweden Hematology Department and HCT Unit G Papanicolaou Hospital Thessaloniki Greece

Institute of Applied Biosciences CERTH Thessaloniki Greece Division of Experimental Oncology and Department of Onco Hematology IRCCS San Raffaele Scientific Institute Milan Italy

Institute of Molecular Genetics and Genetic Engineering University of Belgrade Belgrade Serbia

Laboratory of Medical Informatics Aristotle University of Thessaloniki Thessaloniki Greece

Lund University and Hospital Department of Hematology Lund Stem Cell Center Lund Sweden

Molecular Pathology Unit and Haematology Department Niguarda Cancer Center Niguarda Ca' Granda Hospital Milan Italy

National Research Center for Hematology Moscow Russia

Citace poskytuje Crossref.org

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$a Chronic Lymphocytic Leukemia with Mutated IGHV4-34 Receptors: Shared and Distinct Immunogenetic Features and Clinical Outcomes / $c A. Xochelli, P. Baliakas, I. Kavakiotis, A. Agathangelidis, LA. Sutton, E. Minga, S. Ntoufa, E. Tausch, XJ. Yan, T. Shanafelt, K. Plevova, M. Boudjogra, D. Rossi, Z. Davis, A. Navarro, Y. Sandberg, FJ. Vojdeman, L. Scarfo, N. Stavroyianni, A. Sudarikov, S. Veronese, T. Tzenou, T. Karan-Djurasevic, M. Catherwood, D. Kienle, M. Chatzouli, M. Facco, J. Bahlo, C. Pott, LB. Pedersen, L. Mansouri, KE. Smedby, CC. Chu, V. Giudicelli, MP. Lefranc, P. Panagiotidis, G. Juliusson, A. Anagnostopoulos, I. Vlahavas, D. Antic, L. Trentin, M. Montillo, C. Niemann, H. Döhner, AW. Langerak, S. Pospisilova, M. Hallek, E. Campo, N. Chiorazzi, N. Maglaveras, D. Oscier, G. Gaidano, DF. Jelinek, S. Stilgenbauer, I. Chouvarda, N. Darzentas, C. Belessi, F. Davi, A. Hadzidimitriou, R. Rosenquist, P. Ghia, K. Stamatopoulos,
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$a Purpose: We sought to investigate whether B cell receptor immunoglobulin (BcR IG) stereotypy is associated with particular clinicobiological features among chronic lymphocytic leukemia (CLL) patients expressing mutated BcR IG (M-CLL) encoded by the IGHV4-34 gene, and also ascertain whether these associations could refine prognostication.Experimental Design: In a series of 19,907 CLL cases with available immunogenetic information, we identified 339 IGHV4-34-expressing cases assigned to one of the four largest stereotyped M-CLL subsets, namely subsets #4, #16, #29 and #201, and investigated in detail their clinicobiological characteristics and disease outcomes.Results: We identified shared and subset-specific patterns of somatic hypermutation (SHM) among patients assigned to these subsets. The greatest similarity was observed between subsets #4 and #16, both including IgG-switched cases (IgG-CLL). In contrast, the least similarity was detected between subsets #16 and #201, the latter concerning IgM/D-expressing CLL. Significant differences between subsets also involved disease stage at diagnosis and the presence of specific genomic aberrations. IgG subsets #4 and #16 emerged as particularly indolent with a significantly (P < 0.05) longer time-to-first-treatment (TTFT; median TTFT: not yet reached) compared with the IgM/D subsets #29 and #201 (median TTFT: 11 and 12 years, respectively).Conclusions: Our findings support the notion that BcR IG stereotypy further refines prognostication in CLL, superseding the immunogenetic distinction based solely on SHM load. In addition, the observed distinct genetic aberration landscapes and clinical heterogeneity suggest that not all M-CLL cases are equal, prompting further research into the underlying biological background with the ultimate aim of tailored patient management. Clin Cancer Res; 23(17); 5292-301. ©2017 AACR.
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