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Clinical significance of categorisation of mammographic density for breast cancer prognosis.

Mammographic density reflects comprehensive changes in the mammary gland. The condition of the tumour microenvironment is a possible factor affecting tumour progression, as well as a tumour risk factor. This study aimed to determine whether mammographic density correlates with tumour clinicopathological features and prognosis in breast cancer patients. The analysis involved 163 Japanese women who underwent surgery for breast cancer between 1999 and 2003 in the Nagasaki University Hospital, Japan. Mammographic density was classified according to the breast imaging reporting and data system (BI-RADS) categories 1-4. Age, tumour size, axillary lymph node involvement, steroid receptor (SR) status, histological grade and Nottingham prognostic index (NPI) were analysed by density category and tested for statistically significant differences across categories. A significant difference (P<0.05) by breast-density category was found only for age. SR-negative tumours had significantly worse NPI scores than SR-positive tumours in breast-density categories 2 (P=0.03) and 4 (P<0.001). A high distant-metastasis frequency was observed in category 4 SR negatives (44%) versus category 4 SR positives (4.3%). These findings reveal that although the BI-RADS breast-density category alone is not associated with prognosis in breast cancer, patients who are both category 4 and SR negative have an extremely poor prognosis.

Age Factors↗

[Asymptomatic mediastinal masses: prognosis, attitude and impact of thoracic radiography].

Mediastinal masses remain an interesting diagnostic and therapeutic problem for the clinician. Recent advances in imaging techniques and the increased use of chest roentgenograms in medical practice contribute to early screening of asymptomatic mediastinal masses. From 1965 to 1990, 290 patients with a primary mediastinal cyst or neoplasm were operated and treated in our institution. Among those, 80 patients presented with asymptomatic mediastinal masses. The prognosis of these asymptomatic lesions was evaluated and compared to that of symptomatic ones. Overall, two third of patients who were asymptomatic at diagnosis had a neoplasm, which proved to be malignant in half of the cases. A significantly greater number of patients with malignant neoplasms were asymptomatic at the time of diagnosis during the recent period. The prognosis of these asymptomatic lesions appeared to be better in selected tumoral types (e.g. thymomas, lymphomas) although it was difficult to completely avoid statistical bias. Early radiological detection of mediastinal tumors could improve their prognosis in selected cases. Incidental diagnosis of mediastinal masses by radiological examination should lead to early aggressive diagnostic procedure and treatment.

Adolescent↗

[Extranodal nasal type NK/T-cell lymphoma: the expression of Epstein-Barr virus latent membrane protein 1 and its significance of prognosis].

UNLABELLED: To investigate the expression and prognostic significance of Epstein-Barr virus latent membrane protein 1 in extranodal nasal type NK/T-cell lymphoma in the Chengdu area. METHODS: The expression of latent membrane protein-1 (LMP1) was detected by immunohistochemistry (IHC) and DNA-PCR in 67 cases of extranodal nasal type NK/T-cell lymphoma, and the differences in survival rate between positive and negative expression groups of LMP1-protien and LMP1-DNA were analyzed respectively. RESULTS: Ten (14.93%) cases were positive at LMP1-protein level, and fifty-six (83.58%) were positive at LMP1-DNA level. The total expression rate of LMP1 was 83.58%. No statistically significant difference was observed between the expression of LMP1 and prognosis (P = 0.678) and between the expression of LMP1-DNA and prognosis (P = 0.943). CONCLUSION: LMP1 was shown to be closely associated with extranodal nasal type NK/T-cell lymphoma in Chengdu. The expression rate of LMP1 at protein level was different from that at DNA level. No relationship was found between the prognosis and the LMP1 expression in extranodal nasal type NK/T-cell lymphoma.

Adult↗

[Correlation of clusterin expression to prognosis of bladder carcinoma].

BACKGROUND & OBJECTIVE: Clinically, molecular prognostic markers for bladder carcinoma are still rare. Recently, up-regulation of clusterin protein has been suggested to relate with development and prognosis of several human cancers, but its relation with bladder cancer is unclear. This study was to analyze correlation of expression of clusterin protein to clinicopathologic parameters and prognosis of bladder cancer with tissue chip. METHODS: A tissue microarray containing 81 cases of bladder carcinoma was constructed. The expression of clusterin was detected by immunohistochemistry; its correlation with clinicophathologic parameters was analyzed. RESULTS: Of the 81 cases of bladder cancer, 69 were detectable by immunohistochemistry, 32 (46.4%) of which showed overexpression of clusterin protein. Overexpression rate of clusterin was significantly higher in poorly differentiated (G3 grade) tumors than in well differentiated (G1-G2 grades) tumors (75.0% vs. 34.7%, P=0.002), and was significantly higher in invasive (T2-T4 stages) tumors than in superficial (Ta-T1 stages) tumors (65.4% vs. 34.9%, P=0.014). Expression of clusterin was negatively correlated with prognosis of bladder cancer patients (log-rank=5.88, P=0.015); the recurrence-free survival time of patients with overexpression of clusterin was shorter than that of patients with normal expression of clusterin (37.3 months vs. 48.8 months). CONCLUSION: The overexpression of clusterin might be a molecular prognostic marker of bladder cancer.

Adenocarcinoma↗

[Clinical characteristics and prognosis of diffuse large B-cell lymphoma].

OBJECTIVE: To investigate the clinical characteristics of diffuse large B-cell lymphoma (DLBCL) and the factors affecting its prognosis. METHODS: From 1994 to 2002, 138 patients with DLBCL were confirmed by morphological and immunohistochemical examination. Sex, age, clinical stage, performance status (PS), serum lactate dehydrogenase (LDH), number of extranodal lesions, treatment response, cycles of chemotherapy, B symptom, erythrocyte sedimentation rate (ESR), 5-year survival rate and median survival time (mST) were included as the analysis indeces. RESULTS: Lymph nodes were involved in 87.7% of the patients, and extranodal lesions were found in 60.1%. Five-year survival rate was 41.3% for the entire group. Age, stage, PS, serum LDH, number of extranodal lesions, international prognostic index (IPI) and remission rates were significantly correlated with overall survival (OS) and mST (P < 0.05), However, sex, chemotherapy cycles, B symptom, ESR were not related to OS and mST (P > 0.05). Age, stage, remission rates were identified as independent factors affecting the prognosis. Combination of surgery and chemotherapy was quite impressive in the prolongation of survival of patients with extranodal lesions and gastrointestinal lymphoma compared to those by chemotherapy alone. CONCLUSION: Age, stage, PS, serum LDH, number of extranodal lesions, IPI, chemotherapy cycles and remission rates are significant factors affecting the prognosis in DLBCL patients. Age less than 40 years or >/= 65 years, Stage III-IV, partial remission or progressive disease are demonstrated as poor prognostic factors. Combined treatment is the strategy suggested for DLBCL patients with extranodal lesions.

Adolescent↗

High dose sequential chemotherapy with autologous transplantation versus dose-dense chemotherapy MegaCEOP as first line treatment in poor-prognosis diffuse large cell lymphoma: an "Intergruppo Italiano Linfomi" randomized trial.

BACKGROUND AND OBJECTIVES: Poor prognosis diffuse large cell lymphoma (DLCL) responds poorly to standard chemotherapy. Randomized studies comparing high-dose chemotherapy with autologous stem-cell transplantation (ASCT) against standard chemotherapy have produced conflicting results. Dose-dense chemotherapy with granulocyte colony-stimulating factor (G-CSF) support seems to hold promise. The purpose of this multicenter, randomized trial was to compare failure-free and overall survival in patients with poor prognosis DLCL treated with high-dose sequential (HDS) chemotherapy followed by ASCT or an outpatient dose-dense chemotherapy regimen (MegaCEOP). DESIGN AND METHODS: Between 1996 and 2001, 130 DLCL patients, aged < or = 60 years, with intermediate-high or high-risk disease, according to the International Prognostic Index score, and/or bone marrow involvement were enrolled. Sixty were randomized to HDS chemotherapy plus high-dose mitoxantrone and melphalan with ASCT (arm A) and 66 to the MegaCEOP regimen (6-8 courses of an escalated dose of cyclophosphamide and epirubicin plus vincristine and prednisone with G-CSF every 2-weeks) (arm B); 4 patients were considered ineligible. RESULTS: The complete remission rate was 59% in arm A and 70% in arm B (p = 0.18). After a median follow-up of 78 months, the 6-year failure-free survival was 45% in arm A and 48% in arm B (hazard ratio = 1.15, 95% confidence intervals = 0.72-1.84, p = 0.56). The 5-year overall survival was 49% in arm A and 63% in arm B (hazard ratio = 1.67, 95% confidence interval = 0.98-2.85, p = 0.06). Two cases of secondary acute myeloid leukemia were observed after treatment in group A. INTERPRETATION AND CONCLUSIONS: HDS and ASCT as initial therapy for patients with poor-prognosis DLCL does not provide a benefit over that of outpatient dose-dense MegaCEOP chemotherapy.

Adolescent↗

[Methodological bases for prognosis in medicine].

Current status of prognosis in clinical, experimental and prophylactic medicine is delineated with formulation of the purposes and feasibility of therapeutic and preventive realization of the disease onset and run prediction. Literature and first-hand experience provided the basis for grounding medical prognosis theory. Basic points in the theory are the following: utilization in the prognosis of only a complex of the most significant clinical signs of the disease, the patient's record, social and household, ecological and occupational aspects of the patient's life; comparison of the latter with leading pathogenetic mechanisms underlying the emergence and progression of the pathology; consideration of the relationships between dysfunction and morphology of the organs and systems; simultaneous analysis of the aggression factors, systemic reactivity and resistance of tissue; scrutiny of predisposition to pathological reactions. An essential aspect of medical prediction is a valid choice of mathematical methods of analysis and processing of the clinical information.

Diagnosis↗

Renal dysfunction after heart transplantation: incidence, prognosis and risk factors.

BACKGROUND AND PURPOSE: Despite more than 20 years of experience in heart transplantation, the risk factors for development of chronic renal insufficiency in recipients are not well established. This study assessed the incidence, prognosis and risk factors for renal dysfunction after heart transplantation. METHODS: We conducted a retrospective analysis of all adult patients (n = 132) who survived for more than 1 year after heart transplantation at our institutions from March 1992 through November 2002. Renal dysfunction was defined as serum creatinine of > or = 2.0 mg/dL. The incidence and prognosis of renal dysfunction after heart transplantation was estimated by the Kaplan-Meier method and compared by log rank test. Risk factors for renal dysfunction at 1 year after transplantation were evaluated using a logistic regression model. RESULTS: Renal dysfunction was present in 9 patients (7%) before heart transplantation. The cumulative incidence of renal dysfunction after heart transplantation was 23.0 +/- 3.8%, 36.1 +/- 4.3%, 53.9 +/- 4.9%, and 57.3 +/- 5.8% at 6 months, 1 year, 5 years and 10 years, respectively, after transplantation. The actuarial survival rate in patients without renal dysfunction at 1 year after transplantation was better than for patients with renal dysfunction at 1 year after transplantation (p = 0.046 by log-rank test). Independent risk factors for renal dysfunction at 1 year after transplantation were age at transplantation (odds ratio, 1.07; p = 0.02), pretransplant serum blood urea nitrogen (odds ratio, 1.07; p = 0.048), and serum creatinine at 6 months after transplantation (odds ratio, 17.0; p < 0.001). CONCLUSIONS: There was a high incidence of renal dysfunction after heart transplantation. Patients with renal dysfunction had poor long-term prognosis. Serum creatinine at 6 months after transplantation was the most significant major risk factor, followed by age at transplantation and pretransplant blood urea nitrogen.

Adolescent↗

[Does percutaneous coronary intervention in non-culprit vessels improve the prognosis of acute myocardial infarction complicated by pump failure?].

OBJECTIVES: To evaluate whether percutaneous coronary intervention (PCI)in non-culprit vessel lesions improves the short-term prognosis of acute myocardial infarction complicated by pump failure. METHODS: Fifty-six patients with acute myocardial infarction in hemodynamic subset 4 of Forrester's classification at hospitalization underwent PCI for multiple vessel lesions within 12 hr (6.1 +/- 3.4 hr) of the onset of acute myocardial infarction. No patients had left main trunk lesion. Twenty patients also underwent PCI for non-culprit vessel lesions (multivessel PCI group: M-PCI), but the remaining 36 did not (culprit vessel PCI group: C-PCI). The in-hospital prognosis was investigated from the hospital records. RESULTS: Complete revascularization was accomplished in 18 patients(90%)in the M-PCI. The rates of all in-hospital death were almost equivalent in both groups (M-PCI 30% vs C-PCI 42%, p = 0.21), but the rate of cardiac deaths was higher in the C-PCI than in the M-PCI (42% vs 15%, p < 0.05). Overall major adverse cardiac events occurred more often in the C-PCI than in the M-PCI(58% vs 25%, p < 0.05). Multivariate logistic regression analysis showed complete revascularization(odds ratio 0.11, 95% confidence interval 0.02-0.95, p < 0.05)and duration from onset of acute myocardial infarction to PCI < 6 hr (odds ratio 0.25, 95% confidence interval 0.06-0.98, p < 0.05) were negative predictors of in-hospital cardiac death, and prior myocardial infarction (odds ratio 4.97, 95% confidence interval 1.09-22.67, p < 0.05) was a positive predictor. CONCLUSIONS: PCI of non-culprit vessel lesions might improve the short-term prognosis of patients with acute myocardial infarction and pump failure.

Aged↗

Predictive value of left ventricular function on prognosis in patients undergoing coronary artery bypass surgery.

In order to assess the predictive value of left ventricular (LV) function on prognosis during 16 years of follow-up we retrospectively/prospectively evaluated 320 patients (mean age 55.9 +/- 9.2 years; 44 women, 276 men) undergoing coronary artery bypass surgery. Patients were divided according to the assessed echocardiographically pre- and postoperative LV ejection fraction (LVEF) into two groups: patients with LV dysfunction (EF < 55%) and patients with preserved LV function (EF >or= 55%). In order to assess the prognostic variables, patients were further subdivided into a group with severely depressed LV function (EF <or= 35%). Operative mortality was 2.0% in patients with LVEF < 55% and 4.5% in patients with LVEF <or= 35%, not showing a statistically significant increase of mortality regarding the reduction of preoperative assessed EF. In contrast to the preoperative assessed EF, which could not be found to be a predictive factor of long-term prognosis, in patients with LV dysfunction registered by postoperative assessed EF increased frequency of coronary events as well as a shorter time of its occurrence with acceptable long-term survival was documented. In patients undergoing surgical myocardial revascularization, symptoms of LV failure and postoperative assessed EF were found as independent predictors of prognosis. We can conclude that surgical myocardial revascularization in patients with coronary artery disease and LV failure can be performed safely, providing a relatively long-term period of time without coronary events including cardiac death. Postoperative assessed LV systolic function appeared as a significant predictor of the clinical outcome.

Coronary Artery Bypass↗

[Evaluation of the correlations of cell proliferation activity with lymphatic and vascular invasion and prognosis in gastric carcinoma].

OBJECTIVE: To evaluate bromodeoxyuridine/DNA (BrdUrd/DNA) double-parametric flow cytometric analysis in detection of gastric carcinoma and to study the correlations of cellular BrdUrd labeling index (LI), G(2)/M phase fraction (G(2)/MPF) and DNA content, with lymphatic and vascular invasion and prognosis. METHODS: Sixty cases of fresh tumor samples were examined by BrdUrd/DNA double-parametric flow cytometry. RESULTS: BrdUrd LI and G(2)/MPF values were both significantly higher in patients with lymphatic invasion than those without invasion (P < 0.01). There was statistically significant difference between the 5-year survival rates in cases with and without lymphatic invasion (P < 0.01). Both BrdUrd LI and G(2)/MPF values were significantly higher in patients with lymph node metastasis than those in cases without metastasis (P < 0.01). There was a significant difference in 5-year survival rates between patients with and without lymph node metastases. The incidence of lymph node metastasis was significantly higher in aneuploid carcinoma (P < 0.05), and the patients with aneuploidy had significantly poor prognosis. BrdUrd LI was significantly higher in patients with more than 5 metastatic lymph nodes than those with 1-4 metastatic lymph nodes (P < 0.05) and no metastasis (P < 0.01). G(2)/MPF values in cases with more than 5 and 1-4 metastatic lymph nodes were higher than that in cases with no metastasis (P < 0.01 and P < 0.05, respectively). There were significant differences in 5-year survival rates among patients with no lymph node metastasis, 1-4 nodes metastasis and more than 5 nodes metastasis. G(2)/MPF values were significantly higher in patients with and without vascular invasion (P < 0.01). CONCLUSION: Correlations exist among cellular BrdUrd LI, G(2)/MPF, DNA content and lymphatic involvement, vascular invasions and prognosis in gastric carcinoma.

Adult↗

[Correlation of GST-pi and PCNA expression to prognosis of advanced maxillary sinus squamous cell carcinoma].

BACKGROUND & OBJECTIVE: Tumor markers which relate to cell proliferation and metabolism have seldom been studied in maxillary sinus cancer. This study was conducted to identify the correlation of glutathione S-transferase pi (GST-pi) and proliferating cell nuclear antigen (PCNA) expression to prognosis of advanced maxillary sinus squamous cell carcinoma (SCC). METHODS: The expression of GST-pi and PCNA in 54 specimens of maxillary sinus SCC, 29 specimens of benign maxillary tumor, and 20 specimens of normal nasal mucosa was detected by immunohistochemistry. The correlation of GST-pi and PCNA expression to prognosis of advanced maxillary sinus SCC was analyzed by Kaplan-Meier method. The prognosis was analyzed by Cox multivariate model. RESULTS: The overexpression rates of GST-pi and PCNA were significantly higher in maxillary sinus SCC than in benign maxillary tumor and normal nasal mucosa (74.1% vs. 89.6% and 15.0%, P<0.01; 79.6% vs. 3.4% and 0, P<0.01). The 5-year survival rate was significantly higher in advanced maxillary sinus SCC patients with high expression of GST-pi than in the patients with low expression of GST-pi (34.5% vs. 21.2%, P=0.025); the difference between the patients with high and low expression of PCNA was not significant (18.0% vs. 27.0%, P=0.890). The expression of GST-pi was an independent prognostic factor of advanced maxillary sinus SCC (P=0.039, odds ratio>1). CONCLUSION: The overexpression of GST-pi is an independent prognostic factor of advanced maxillary sinus SCC, but that of PCNA isn't.

Adult↗

[Expression of S100-labeled dendritic cells in glottic squamous cell carcinoma and its correlation to prognosis].

BACKGROUND & OBJECTIVE: Dendritic cells (DCs) are the most important antigen-presenting cells, and can synthesize and secrete S100 protein. This study was designed to investigate the expression of S100-labeled DCs in glottic squamous cell carcinoma, and analyze its correlation to the prognosis. METHODS: The expression of S100-labeled DCs in peritumoral tissues of 111 specimens of gllotic squamous cell carcinoma was detected by immunohistochemistry; 17 specimens of normal tissues were used as control. The correlation of S100-labeled DCs expression to prognosis of the 111 patients was evaluated. RESULTS: The positive rates of S100-labeled DCs were 51.35% (57/111) in peritumoral tissues of gllotic squamous cell carcinoma, and 0 in normal tissues. The 5-year survival rate was significantly higher in S100-positive group than in S100-negative group (72.31% vs. 53.91%, P=0.030). CONCLUSIONS: The glottic squamous cell carcinoma patients with obvious infiltration of S100-labeled DCs may achieve good prognosis.

Adult↗

[CD34+ antigen expression relating to prognosis in acute myeloid leukemia].

To explore CD34(+) antigen expression in new diagnosed acute myeloid leukemia (AML) and analyze the prognosis for CD34(+) AML patients, the expression of antigen CD34 in 238 AML patients was detected by indirect immunofluorescence assay. The results showed that CD34 in 92 out of the 238 patients (38.7%) were positive, there was relationship between the CD34(+) expression and FAB subtypes (M(0), M(1)), and no CD34(+) expression was observed in M(3) subtypes. The complete remission rate of CD34(+) AML patients was 32%, which was lower than that of CD34(-) AML (61%). The lymphoid-associated antigen (CD7) was significantly increased in CD34(+) AML patients, compared with CD34(-) patients (P < 0.05). It is concluded that CD34(+) AML patients show poor prognosis and lower CR rate. The detection of CD34 expression is of some value in predicting prognosis in AML.

Adolescent↗

Second surgery and the prognosis of choroid plexus carcinoma--results of a meta-analysis of individual cases.

Tumors of the choroid plexus (CPT) are rare. While choroid plexus papillomas (CPP) are regarded as benign, choroid plexus carcinomas (CPC) have a dismal prognosis, and there is limited information available regarding the best treatment. Maximal possible surgery is generally believed to be the major prognostic factor, but data to answer the question, of whether second surgery improves the prognosis of CPC have been missing. A database of all cases of CPT reported in the literature until 2004 was created to determine prognostic factors and analyze therapeutic modalities. Eight hundred and fifty-seven cases of CPT were identified. Three hundred and forty-seven patients had CPC, 15 atypical choroid plexus papillomas (APP) and 495 CPP. Besides histology, complete resection was confirmed to be the most important prognostic factor in each of the subgroups defined by the three histological diagnoses. In CPP, complete resection was more frequently achieved (80.4%) than in APP (61.5%) or CPC (39.6%). Among the subgroup of incompletely resected CPC, 22.6% of the patients had second surgery. The prognosis of these patients appeared better when compared to incompletely resected CPC without second surgery (2-year overall survival 69% versus 30%). There was no such difference within the subgroup of CPP. This study suggests, if complete resection is not possible in the first surgery of a choroid plexus carcinoma, a second resection should be considered.

Adolescent↗

[The factors related to the prognosis of solitary hepatocellular carcinoma after radiofrequency ablation].

BACKGROUND/AIMS: Several risk factors, such as size and location, are related to local recurrence after radiofrequency ablation (RFA) in the treatment of hepatocellular carcinoma (HCC). The objectives of this study were to clarify factors related to prognosis. METHODS: From October 1999 to December 2002, we performed RFA for 107 consecutive patients with solitary HCC. We evaluated spiral computed tomography and serum alpha-fetoprotein level every 3 months after RFA. Seven possible factors for prognosis were analyzed using the Cox proportional hazards regression model: tumor size, tumor location, age, sex, etiology, platelet count, and Child-Pugh classification. Overall survival and disease free survival rate were estimated using the Kaplan-Meier method, and differences between two groups were compared using the log rank test. RESULTS: The Kaplan-Meier estimates of overall survival after radiofrequency ablation were 90.5% at 12 months, 67.4% at 24 months and 46.4% at 36 months and disease free survival were 71.4%, 46.7% and 20.9%, respectively. Using the Cox proportional hazards regression model, it was shown that with regard to overall survival and disease free survival, Child-Pugh classification (P=0.001, P=0.026) and platelet count (P<0.001, P=0.002) were statistically significant factors. The other factors did not have a statistically significant relationship to overall survival and disease free survival. CONCLUSIONS: The size and location known as local recurrence factors were not statistically significant with regard to survival and disease free survival. The Child-Pugh classification and platelet count, that reflect the liver function at the time of RFA, were significant factors for prognosis.

Adult↗

The preserved expression of neuropilin (NRP) 1 contributes to a better prognosis in colon cancer.

Vascular endothelial growth factor A (VEGF-A) plays an essential role in tumor progression through stromal neovascularization in malignant solid tumors. Neuropilin (NRP) is considered to be the specific receptor for limited types of VEGF-A isoform, VEGF165. The clinicopathological implications of NRP are not well understood in colon cancer, while almost all colon cancers overexpressed VEGF-A. We examined the expression levels of NRP1 and NRP2 genes in 54 colon cancer cases and paired extraneoplastic tissue with quantitative real-time polymerase chain reaction. The gene expression levels of NRP1 in the tumor (0.431+/-0.583) were significantly decreased compared to those in the extraneoplastic tissue (0.754+/-0.799) (paired t-test, p=0.0208). On the other hand, the gene expression levels of NRP2 in the tumor (0.763+/-0.791) were not decreased compared to those in the extraneoplastic tissue (0.508+/-0.386) (paired t-test, p=0.0511). Twenty cases, with preserved expression of the NRP1 gene in the tumor, showed a better prognosis as compared to the 34 cases with decreased NRP1 expression (p=0.0258, log-rank test). No significant relationship was noted between NRP2 gene expression and prognosis. The results suggested that preserved NRP1 expression provides colon cancer patients with a better prognosis.

Adenocarcinoma↗

Significance of VH genes mutation status for prognosis of CLL patients.

AIM: The aim of this study was to evaluate significance of VH mutation status for prognosis of B-cell chronic lymphocytic leukemia (B-CLL) patients in comparison with other prognostic markers. MATERIALS AND METHODS: The VH mutation status was evaluated in 43 B-CLL patients by RT-PCR amplification and nucleotide sequencing, and CD38 expression - by two-color FACS analysis. The prognostic influence of VH mutation rate and CD38 expression level was tested by different statistical methods. RESULTS: The increasing number of advanced cases over the follow-up period, shorter median time from diagnosis to start of second line therapy, worse response to fludarabine treatment, poor survival for early stages B-CLL were found in unmutated versus mutated CLL patients. The significance of CD38 expression for CLL prognosis was revealed as predictor for response for fludarabine treatment and time of progression in advanced stages. The correlation between CD38 expression and VH mutation status was not found. CONCLUSION: Simultaneous determination of VH mutation status and CD38 expression may be helpful for prediction of CLL prognosis.

ADP-ribosyl Cyclase 1↗