Chronic leukemic B-cell disorders and trisomy 12 : a study of surface markers, protein expression and clinical course
Author: Hjalmar, Viktoria
Date: 2001-04-06
Location: CMM:s föreläsningssal, Karolinska sjukhuset
Time: 9.00
Department: Institutionen för medicin / Department of Medicine
Abstract
Chronic lymphocytic leukemia of B-cell type (CLL) is the most common
disease entity of chronic leukemic B-cell disorders (CLBD). CLL is the
most frequent leukemia in the Western world and the incidence is
increasing. The clinical course is very variable and specific therapy is
not always needed. Therefore, valid prognostic markers are of great
importance managing the individual patient. Disease stage is determined
in most cases and has a prognostic value. Chromosomal abnormalities have
also been evaluated as prognostic markers in CLDB. The most common
numerical chromosomal aberration is trisomy 12. The purpose of this
thesis was to use fluorescence in situ hybridization (FISH) to detect
trisomy 12 in CLBD and to characterize the patients with trisomy 12 from
a biological, clinical, and prognostic perspective.
Totally 156 patients with CLBD were evaluated for the occurrence of trisomy 12. The findings were correlated with the morphology of the leukemic cells and the surface expression of CD25 (IL2- receptor), CD54 (ICAM-1), CD95 (Apo 1) and with the intracellular murine double minute (MDM2) protein. Repeat FISH analyses were performed to study the leukemic clone during the course of the disease.
Trisomy 12 was detected in 2-54% of the blood mononuclear cells (MNC) in 18/118 (15%) of the CLBD patients. The aberration was found in 24% of patients with tumor cells with atypical morphology including lymphoplasmacytoid features, while only 2% of the cases with a typical morphology had trisomy 12. The trisomic patients had higher S-LDH, expressed a monoclonal band more frequently, had shorter median time to treatment and reduced survival compared with the disomic cases.
Analyses of the occurrence of trisomy 12 in different morphologically defined lymphoid cells by combined conventional cell staining and FISH (MGG/FISH), showed that the aberration was as frequent in morphologically atypical as in typical cells.
By sequential FISH analyses, we found that acquisition of trisomy 12 during the course of the disease was a rare event (2/60). In all cases with trisomy 12 (n=17), the trisomic clone expanded as the disease progressed. Therapy with alkylators and combination regimens significantly reduced the trisomic clone. In contrast, after treatment with purine analogs a relative increase of the trisomic clone was observed.
Using flow cytometry, CLL patients had a higher frequency of B-cells expressing CD25 than controls. High expression of CD25 (>30% of the B-cells) was associated with a significantly shorter median time to treatment.
CLL patients had a significantly higher percentage of mononuclear cells (MNC) expressing the MDM2 protein than controls. Patients with trisomy 12 had significantly more MDM2 expressing cells than the disomic cases. This extra copy of chromosome 12 can not be the only explanation for the difference, since most cases had more MDM2 expressing cells than trisomic MNC.
Even though trisomy 12 was associated with several of the studied biological and clinical factors neither appeared specific for CLBD patients with trisomy 12.
Totally 156 patients with CLBD were evaluated for the occurrence of trisomy 12. The findings were correlated with the morphology of the leukemic cells and the surface expression of CD25 (IL2- receptor), CD54 (ICAM-1), CD95 (Apo 1) and with the intracellular murine double minute (MDM2) protein. Repeat FISH analyses were performed to study the leukemic clone during the course of the disease.
Trisomy 12 was detected in 2-54% of the blood mononuclear cells (MNC) in 18/118 (15%) of the CLBD patients. The aberration was found in 24% of patients with tumor cells with atypical morphology including lymphoplasmacytoid features, while only 2% of the cases with a typical morphology had trisomy 12. The trisomic patients had higher S-LDH, expressed a monoclonal band more frequently, had shorter median time to treatment and reduced survival compared with the disomic cases.
Analyses of the occurrence of trisomy 12 in different morphologically defined lymphoid cells by combined conventional cell staining and FISH (MGG/FISH), showed that the aberration was as frequent in morphologically atypical as in typical cells.
By sequential FISH analyses, we found that acquisition of trisomy 12 during the course of the disease was a rare event (2/60). In all cases with trisomy 12 (n=17), the trisomic clone expanded as the disease progressed. Therapy with alkylators and combination regimens significantly reduced the trisomic clone. In contrast, after treatment with purine analogs a relative increase of the trisomic clone was observed.
Using flow cytometry, CLL patients had a higher frequency of B-cells expressing CD25 than controls. High expression of CD25 (>30% of the B-cells) was associated with a significantly shorter median time to treatment.
CLL patients had a significantly higher percentage of mononuclear cells (MNC) expressing the MDM2 protein than controls. Patients with trisomy 12 had significantly more MDM2 expressing cells than the disomic cases. This extra copy of chromosome 12 can not be the only explanation for the difference, since most cases had more MDM2 expressing cells than trisomic MNC.
Even though trisomy 12 was associated with several of the studied biological and clinical factors neither appeared specific for CLBD patients with trisomy 12.
List of papers:
I. Hjalmar V, Kimby E, Matutes E, Sundstrom C, Jacobsson B, Arvidsson I, Hast R (1998). "Trisomy 12 and lymphoplasmacytoid lymphocytes in chronic leukemic B-cell disorders" Haematologica 83(7): 602-609
Pubmed
II. Hjalmar V, Kimby E, Matutes E, Sundstrom C, Wallvik J, Hast R (2000). "Atypical Lymphocytes in B-Cell Chronic Lymphocytic Leukemia and Trisomy 12 Studied by Conventional Staining Combined with Fluorescence in Situ Hybridization" Leuk Lymphoma 37(5-6): 571-576
Pubmed
III. Hjalmar V, Hast R, Kimby E (2001). "Sequential fluorescence in situ hybridization analyses for trisomy 12 in chronic leukemic B-cell disorders" Haematologica 86(2)
::
174-180
Pubmed
IV. Hjalmar V, Hast R, Kimby E (2001). "Chronic leukaemic B-cell disorders and trisomy 12 : cell surface expression of CD25, CD54 and CD95" (Submitted)
V. Hjalmar V, Christensson B, Gustafsson B, Kimby E (2001). "Expression of MDM2 protein and relation to trisomy 12 in chronic lymphocytic leukemia" (Manuscript)
I. Hjalmar V, Kimby E, Matutes E, Sundstrom C, Jacobsson B, Arvidsson I, Hast R (1998). "Trisomy 12 and lymphoplasmacytoid lymphocytes in chronic leukemic B-cell disorders" Haematologica 83(7): 602-609
Pubmed
II. Hjalmar V, Kimby E, Matutes E, Sundstrom C, Wallvik J, Hast R (2000). "Atypical Lymphocytes in B-Cell Chronic Lymphocytic Leukemia and Trisomy 12 Studied by Conventional Staining Combined with Fluorescence in Situ Hybridization" Leuk Lymphoma 37(5-6): 571-576
Pubmed
III. Hjalmar V, Hast R, Kimby E (2001). "Sequential fluorescence in situ hybridization analyses for trisomy 12 in chronic leukemic B-cell disorders" Haematologica 86(2)
::
174-180
Pubmed
IV. Hjalmar V, Hast R, Kimby E (2001). "Chronic leukaemic B-cell disorders and trisomy 12 : cell surface expression of CD25, CD54 and CD95" (Submitted)
V. Hjalmar V, Christensson B, Gustafsson B, Kimby E (2001). "Expression of MDM2 protein and relation to trisomy 12 in chronic lymphocytic leukemia" (Manuscript)
Issue date: 2001-03-16
Publication year: 2001
ISBN: 91-628-4664-7
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