Analysis of the treatment and influencing factors of chronic lymphocytic leukemia
Shen Jing
Wei Na
Fu Li
Huang Dayong
Wang Zhao
Abstract：Objective To analyze the effect of treatment ,therapy response and prognosis of patients with chronic lymphocytic leukemia ( CLL) .Methods The clinical and laboratorial data of 65 CLL patients were ana-lyzed retrospectively .Flow cytometry was applied to detect Zeta-chain associated protein kinase 70 kDa ( Zap70 ) expression , mutational status of the immunoglobulin heavy chain variable (IgHV) gene were detected by reverse transcription polymerase chain reaction;chromosomal changes were checked by Fluorescence in situ hybridization ( FISH) test.The patients were divided into 3 groups by different treatment strategies: fludarabine based chemo-therapy(32 patients), rituximab and fludarabine combining treatment (20 patients) and other treatments group (13 patients).Fludarabine based chemotherapy included FC and FCD regime ,1 cycle for 28 days, over 4 cycles. F was Fludarabin 25 mg/(m2? d) for 3 days, C was cyclophosphamide 200 mg/(m2? d) for 3 days, D was dex-amethasone 9 mg/( m2? d) for 5 days.Rituximab and fludarabine combining treatment included rituximab 375 mg/m2 for 1 day before chemotherapy .Other treatments included chlorambucil 6 mg/( m2? d) for 30 days;dose was adjusted by complete blood count analysis .Effective rates were compared among different groups . Results ①Zap70 expression was checked in 52 patients and 16 were positive .The effective rate was higher in negative patients than that in positive patients [43.8%(7/16) vs 86.1%(31/36),P<0.05].The mutational status of IgHV genes was detected in 34 patients and 21 were positive .The effective rate was higher in positive pa-tients than that in negative patients [95.2%(20/21) vs 61.5%(8/13),P<0.05].Twenty four cases performed Fluorescence in situ hybridization ( FISH) chromosomal changes test which showed that 17 patients had at least 1 genetic abnormalities and 7 havd normal karyotype .②Of 32 patients, 23 patients (71.9%) receiving fludarabine based chemotherapy achieved an effective rate ( complete response +partial response ) .Rituximab and fludarabine treatment achieved an effective rate of 95.0%(19/20).Of 13 patients who received other treatment , effective rate was 30.8%(4/13).Compared with other treatment groups, there was a statistical significance (P <0.01). Conclusions CLL is a clinical and molecular heterogenous disease .Its clinical characteristics , cytogenetic analy-ses and Zap70 and IgHV gene mutation are related to prognosis .Fludarabine based chemotherapy and rituximab combined with treatment can improve CLL treatment .
Keywords：Chronic lymphocytic leukemiaZeta-chain associated protein kinase 70 kDaImmuno-globulin heavy chain variable genesFludarabine
Publication Date：2014-01-01
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 1317-1320,1321 )