Details

Autor(en) / Beteiligte

• Abdelbaky, Salma B
• Giacopelli, Brian
• Rabe, Kari G
• Yamaguchi, Kyoko
• Wu, Yue-Zhong
• Yan, Huihuang
• Shanafelt, Tait D
• Parikh, Sameer A
• Ding, Wei
• Hampel, Paul J
• Brown, Sochilt
• Cerhan, James R
• Vachon, Celine M
• Kay, Neil E
• Hanson, Curtis A
• Parker, Alexander S
• Braggio, Esteban
• Slager, Susan L
• Oakes, Christopher C

Titel

Prediction of outcomes for high-count monoclonal B lymphocytosis using an epigenetic and immunogenetic signature

Ist Teil von

• Blood, 2024-04, Vol.143 (17), p.1752-1757

Ort / Verlag

United States

Erscheinungsjahr

2024

Quelle

MEDLINE

Beschreibungen/Notizen

• Monoclonal B-cell lymphocytosis (MBL) progresses to chronic lymphocytic leukemia (CLL) requiring therapy at 1% to 5% per year. Improved prediction of progression would greatly benefit individuals with MBL. Patients with CLL separate into 3 distinct epigenetic subtypes (epitypes) with high prognostic significance, and recently the intermediate epitype has been shown to be enriched for high-risk immunoglobulin lambda variable (IGLV) 3-21 rearrangements, impacting outcomes for these patients. Here, we employed this combined strategy to generate the epigenetic and light chain immunoglobulin (ELCLV3-21) signature to classify 219 individuals with MBL. The ELCLV3-21 high-risk signature distinguished MBL individuals with a high probability of progression (39.9% and 71.1% at 5 and 10 years, respectively). ELCLV3-21 improved the accuracy of predicting time to therapy for individuals with MBL compared with other established prognostic indicators, including the CLL international prognostic index (c-statistic, 0.767 vs 0.668, respectively). Comparing ELCLV3-21 risk groups in MBL vs a cohort of 226 patients with CLL revealed ELCLV3-21 high-risk individuals with MBL had significantly shorter time to therapy (P = .003) and reduced overall survival (P = .03) compared with ELCLV3-21 low-risk individuals with CLL. These results highlight the power of the ELCLV3-21 approach to identify individuals with a higher likelihood of adverse clinical outcome and may provide a more accurate approach to classify individuals with small B-cell clones.