OncohematologyOncohematologyОнкогематология1818-83462413-4023Publishing House ABV Press61110.17650/1818-8346-2007-0-1-17-23BIOLOGY OF HEMATOLOGIC MALIGNANCIESБИОЛОГИЯ ГЕМОБЛАСТОЗОВMolecular-genetic markers: prognostic factors in B-cell chronic lymphocytic leukemiaМолекулярно-генетические маркеры как факторы прогноза при хроническом В-клеточном лимфолейкозеZakharovaA. I.ЗахароваА. И.
Russian Federation

Moscow

Москва

ObukhovaT. N.ОбуховаТ. Н.
Russian Federation

Moscow

Москва

National Center for HematologyГематологический научный центр, РАМН220220071172322112022221120222007https://oncohematology.abvpress.ru/ongm/article/view/611

Molecular-genetic markers are the most important prognostic factors of B-cell chronic lymphocytic leukemia (B-CLL). These markers are VH mutational status, it’s surrogate markers — СD38, ZAP-70, LPL и ADAM29 and the aim of this study - cytogenetic abnormalities. We have hold cytogenetic research of blood, bone marrow and lymph nodes cells of 135 non-treated patients.

We recognized several cytogenetic features of the B-CLL form, which characterizes by massive peripheral, thoracic, and abdominal lym-phadenopathy and not large leucocytes counts. 11q23 deletion is defined in most of such cases, trisomy 12 — significantly more often than in other B-CLL forms, and del13q14 is never revealed in patients with this B-CLL form, though it is the most frequent aberration in B-CLL. We divided all B-CLL cases in three prognostic groups: favorable group are the patients without cytogenetic aberrations or with del13q14 as the single chromosome abnormality; the group of intermediate prognosis are the patients with trisomy 12, and also the patients with del11q23, which is traditionally divided to unfavorable prognostic factors; unfavorable group are the patients with del17p13 or complex abnormalities of karyotype.

Cytogenetic study helps to define the prognosis of B-CLL and to reveal the patients of «risk group», who need the early treatment.

Молекулярно-генетические маркеры — важнейшие факторы прогноза при В-клеточном хроническом лимфолейкозе (В-ХЛЛ). К ним относятся мутационный статус генов вариабельного региона иммуноглобулинов (Vh), его суррогатные маркеры и цитогенетические нарушения, которым была посвящена наша работа.

Мы провели цитогенетическое исследование клеток крови, костного мозга и лимфатических узлов 135 больных В-ХЛЛ, которым ранее не проводилась специфическая терапия.

Нами выявлены следующие цитогенетические особенности опухолевой формы В-ХЛЛ: делеция 11q23 — в большинстве случаев, трисомия хромосомы 12 — достоверно чаще, чем при других формах В-ХЛЛ, а делеция 13q14 — никогда, несмотря на то что это самая часто встречающаяся при В-ХЛЛ аберрация.

Мы выделили 3 прогностические группы больных В-ХЛЛ: благоприятная — больные, у которых не было выявлено никаких нарушений кариотипа, и больные с одной хромосомной аберрацией — делецией 13q14; группа «промежуточного» прогноза, к которой относятся больные не только с трисомией хромосомы 12, но и с делецией 11q23, которую традиционно относят к факторам неблагоприятного прогноза; и неблагоприятная — больные с делецией 17р13 и комплексными нарушениями кариотипа.

Таким образом, цитогенетическое исследование помогает определить прогноз В-ХЛЛ и, следовательно, выявить пациентов «группы риска», требующих раннего назначения терапии.

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