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The American College of Surgeons Commission on Cancer and the American Cancer Society: The National Cancer Data Base report on age, gender, treatment, and outcomes of patients with chronic lymphocytic leukemia
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1 Diehl LF, Karnell LH, Menck HR: The American College of Surgeons Commission on Cancer and the American Cancer Society: the National Cancer Data Base report on age, gender, treatment, and outcomes of patients with chronic lymphocytic leukemia. Cancer 1999, 86:2684-2692. This report uses National Cancer Data Base (NCDB) data on patients from a broad spectrum of hospitals in the United States from 1985 to 1990 and from 1991 to 1995. Comparisons were made with US population figures for 1990 and with series published over the last 70 years. Patients with CLL had an average survival age of 69.6 years and comprised 22.6% of the 108,396 cases of leukemia in the database. The risk of developing CLL increased progressively with age and did not plateau. The 5-year relative survival for age groups younger than 40 years of age, 40 to 59, 60 to 79, and older than 80 years of age was 69.5%, 72.2%, 63.1%, and 41.7%, respectively. As such, CLL, not comorbid disease, caused the greatest percentage of deaths. Moreover, CLL is a more fatal disease among older individuals because of the disease itself, not because of comorbid conditions.
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8 Döhner H, Stilgenbauer S, Dohner K, et al.: Chromosome aberrations in B-cell chronic lymphocytic leukemia: reassessment based on molecular cytogenetic analysis. J Mol Med 1999, 77:266-281. This is an excellent review of our current understanding of the molecular cytogenetics of CLL.
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The prognostic significance of 13q14 deletions in chronic lymphocytic leukemia
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9 Starostik P, O'Brien S, Chung CY, et al.: The prognostic significance of 13q14 deletions in chronic lymphocytic leukemia. Leuk Res 1999, 23:795-801. This study confirms the prevalence of 13q14 deletion in CLL and suggests that this deletion may identify early stage patients with more aggressive disease.
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10 Hogan WJ, Tefferi A, Borell TJ, et al.: Prognostic relevance of monosomy at the 13q14 locus detected by fluorescence in situ hybridization in B-cell chronic lymphocytic leukemia. Cancer Genet Cytogenet 1999, 110:77-81. This study confirms the prevalence of 13q14 deletions in CLL and suggests that patients with this abnormality have a better treatment-free survival than those with trisomy 12.
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Exclusion of Leu1 and Leu2 genes as tumor suppressor genes in 13q14.3-deleted CLL
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11 Rondeau G, Moreau I, Bézieau S, et al.: Exclusion of Leu1 and Leu2 genes as tumor suppressor genes in 13q14.3-deleted CLL. Leukemia 1999, 13:1630-1632.
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Evaluation of trisomy 12 by fluorescence in situ hybridization in peripheral blood, bone marrow and lymph nodes of patients with B-cell chronic lymphocytic leukemia
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12 Liso V, Capalbo S, Lapietra A, et al.: Evaluation of trisomy 12 by fluorescence in situ hybridization in peripheral blood, bone marrow and lymph nodes of patients with B-cell chronic lymphocytic leukemia. Haematologica 1999, 84:212-217. Using fluorescence in situ hybridization, this study found a higher proportion of trisomy 12 cells in the lymph nodes than in the blood or marrow of CLL patients. As such, it appears that the CLL cells with trisomy 12 may have different cell distributions than CLL cells without this genetic abnormality. This suggests that leukemia cells with trisomy 12 have an enhanced tropism or proliferate advantage in the lymph node.
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Analysis of progenitor cell involvement in CLL by simultaneous immunophenotypic and genotypic analysis at the single cell level
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14 Gahn B, Wendenburg B, Troff C, et al.: Analysis of progenitor cell involvement in CLL by simultaneous immunophenotypic and genotypic analysis at the single cell level. Br J Haematol 1999, 105:955-959.
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The sequential analysis of trisomy 12 in B-cell chronic lymphocytic leukaemia
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18 Einhorn S, Burvall K, Juliusson G, et al.: Molecular analyses of chromosome 12 in chronic lymphocytic leukemia. Leukemia 1989, 3:871-874.
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11q deletions identify a new subset of B-cell chronic lymphocytic leukemia characterized by extensive nodal involvement and inferior prognosis
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20 Döhner H, Stilgenbauer S, James MR, et al.: 11q deletions identify a new subset of B-cell chronic lymphocytic leukemia characterized by extensive nodal involvement and inferior prognosis. Blood 1997, 89:2516-2522.
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Reduced expression of adhesion molecules and cell signaling receptors by chronic lymphocytic leukemia cells with 11q deletion
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21 Sembries S, Pahl H, Stilgenbauer S, et al.: Reduced expression of adhesion molecules and cell signaling receptors by chronic lymphocytic leukemia cells with 11q deletion. Blood 1999, 93:624-631. This study found that CLL cells with 11q deletion carried significantly lower levels of the adhesion molecules CD11a/CD18 (integrin αL/β2), CD11c/CD18 (integrin αX/β2), CD31 (PECAM-1), CD48, and CD58 (LFA-3) than leukemia cells lacking this genetic abnormality. Furthermore, CLL cells with 11q deletion expressed less the cell signaling receptors CD45 (leukocyte common antigen), CD6, CD35 (complement receptor 1), and CD39. The authors propose that decreased levels of functionally relevant adhesion molecules and of cell signaling receptors may contribute to the pathogenesis of the subgroup of CLL characterized by 11q22-q23 deletion.
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Allelic loss of 11sq13 as detected by MEN1-FISH is not associated with mutation of the MEN1 gene in lymphoid neoplasms
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22 Thieblemont C, Pack S, Sakai A, et al.: Allelic loss of 11sq13 as detected by MEN1-FISH is not associated with mutation of the MEN1 gene in lymphoid neoplasms. Leukemia 1999, 13:85-91.
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Deficiency of the ATM protein expression defines an aggressive subgroup of B-cell chronic lymphocytic leukemia
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ATM mutations in B-cell chronic lymphocytic leukemia
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27 Bullrich F, Rasio D, Kitada S, et al.: ATM mutations in B-cell chronic lymphocytic leukemia. Cancer Res 1999, 59:24-27. This study found that the ATM gene is mutated in the CLL cells of a fraction of patients. Moreover, these investigators found that such mutations can be present in the germ line DNA of patients, suggesting that ATM heterozygotes may be predisposed to CLL.
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Bullrich, F.1
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Somatic ATM mutations indicate a pathogenic role of ATM in B-cell chronic lymphocytic leukemia
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29 Schaffner C, Stilgenbauer S, Rappold GA, et al.: Somatic ATM mutations indicate a pathogenic role of ATM in B-cell chronic lymphocytic leukemia. Blood 1999, 94:748-753. This study examined the germ line DNA of CLL with mutations in the ATM gene at 11q22-q23. In four cases analyzed, the ATM alterations were not present in the germ line. The authors propose that most ATM mutations in CLL are of somatic origin.
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Blood
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Schaffner, C.1
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30 Stankovic T, Weber P, Stewart G, et al.: Inactivation of ataxia telangiectasia mutated gene in B-cell chronic lymphocytic leukaemia [comments]. Lancet 1999, 353:26-29. Germline mutations in the ATM gene at 11q22-q23 were detected in two of six studied CLL patients who had leukemia cells with ATM mutations. The authors suggest that carriers of ATM mutations may be at a particular risk for the development of CLL and that this may partly explain the known genetic susceptibility to this disease.
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Deletion of 6q27 in chronic lymphocytic leukemia and multiple myeloma detected by fluorescence in situ hybridization
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32 Amiel A, Mulchanov I, Elis A, et al.: Deletion of 6q27 in chronic lymphocytic leukemia and multiple myeloma detected by fluorescence in situ hybridization. Cancer Genet Cytogenet 1999, 112:53-56. Using fluorescence in situ hybridization, this study found deletions at 6q27, rather than at 6q23, in leukemia cells of 21% of patients with CLL, suggesting that this genetic abnormality is not specific to intermediate grade lymphomas.
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33 Callet-Bauchu E, Salles G, Gazzo S, et al.: Translocations involving the short arm of chromosome 17 in chronic B-lymphoid disorders: frequent occurrence of dicentric rearrangements and possible association with adverse outcome. Leukemia 1999, 13:460-468. By conventional karyotype, this study identified unbalanced translocations involving 17p in 14 out of 123 (11%) CLL/small lymphocytic lymphoma patients with clonal abnormalities. In all cases, translocations led to a monosomy 17p and to a TP53 monoallelic deletion associated with a more adverse clinical outcome.
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Unmutated Ig V-H genes are associated with a more aggressive form of chronic lymphocytic leukemia
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H genes (P = .0008). These authors propose that CLL comprises two different diseases with different clinical courses: one, arising from a memory B cell, has a relatively benign course; whereas the other, arising from a naive B cell, is relatively malignant.
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37 Damle RN, Wasil T, Fais F, et al.: Ig V gene mutation status and CD38 expression as novel prognostic indicators in chronic lymphocytic leukemia. Blood 1999, 94:1840-1847. This study found that the immunoglobulin variable region gene (V gene) mutation status and the expression levels of CD38 on CLL cells were associated with differences in clinical outcome.
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An alternatively spliced form of CD79b gene may account for altered B-cell receptor expression in B-chronic lymphocytic leukemia
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44 Alfarano A, Indraccolo S, Circosta P, et al.: An alternatively spliced form of CD79b gene may account for altered B-cell receptor expression in B-chronic lymphocytic leukemia. Blood 1999, 93:2327-2335. This study found that the low level expression of surface immunoglobulin and associated accessory proteins, CD79a and CD79b, in CLL was associated with expression of a relatively high amount of the alternatively spliced transcript encoding CD79b. Because normal B cells also present this variant, the authors propose that the mechanism of CD79b posttranscriptional regulation might reflect the activation stage of the normal B cell from which CLL derives.
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Blood
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CD5-small B-cell leukemias are rarely classifiable as chronic lymphocytic leukemia
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CD79a detected by ZL7.4 separates chronic lymphocytic leukemia from mantle cell lymphoma in the leukemic phase
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