Immunoglobulin (Ig) mutational status could be used as a prognostic marker for clinical outcome in chronic lymphocytic leukemia (CLL)

06-23-2006

"The Ig mutational status in B-cell CLL distinguishes two subsets of patients with different prognosis. Ig status detection is commonly performed with a panel of V-H, family-specific primers," scientists in Italy reported.

"Although this method detects clonal VDJ rearrangement in virtually all cases, it is technically cumbersome and therefore not widely used clinically. Here, we describe a simple and rapid method to establish the mutational status of IgV(H) in CLL. The method is based on a consensus V-H FR2 primer, used in both polymerase chain reaction (PCR) and sequencing reactions," explained R. Marasca and colleagues, University of Modena & Reggio Emilia.

"Overall, monoclonal B-cell populations were detected in 163 of 189 CLL patients (86%). The prognostic value of IgV(H) mutational status was then evaluated by analyzing survival in 146 CLL cases using different V-H homology cutoffs. CLL prognostic groups were best separated by the classical 98% cutoff. Median survival was 127 and 206 months in unmutated and mutated CLL cases, respectively (p=.0023). V-H FR2 consensus and V-H, family PCR were compared in 41 cases, correctly assigning all cases by both methods."

The researchers concluded, "Therefore, we suggest a sequential strategy to detect immunoglobulin mutational status in CLL patients by first using the approach described in this study followed by alternative V-H family-specific PCRs for negative cases."

Marasca and colleagues published their study in the Journal of Molecular Diagnostics (Immunoglobulin mutational status detected through single-round amplification of partial V-H region represents a good prognostic marker for clinical outcome in chronic lymphocytic leukemia. J Mol Diagn, 2005;7(5):566-574).

For additional information, contact R. Marasca, University of Modena & Reggio Emilia, Dept. Hematology & Oncology, Via Pozzo 71, I-41100 Modena, Italy.