Abstract:
The clinical outcome of lymphocytic leukemia (CLL) is quite heterogeneous. The purpose of this observational study was to investigate the clinical merit of measuring plasma galectin-9 and CXCL-13 concentrations as predictors of CLL activity, prognosis, and early indicators of therapeutic response. These biomarkers were compared with other prognostic indicators, progression-free survival (PFS), time to first treatment (TTT), and overall survival (OS) over a follow-up period (4 years). First, plasma galectin-9 and CXCL-13 concentrations were analyzed in CLL patients at the time of diagnosis as well as healthy controls. Compared to controls, CLL patients had significantly higher serum levels of CXCL-13 and galectin-9. Second, we observed that CLL patients with high soluble CXCL-13 and galectin-9 levels had advanced clinical stages, poor prognosis, 17p del, short PFS, short TTT, and therapy resistance. The levels of CXCL-13, β2-microglobulin, LDH, CD38%, and high grade of Rai-stage were all strongly correlated with the galectin-9 levels. Soluble CXCL-13 and galectin-9 had very good specificity and sensitivity in detecting CLL disease progression and high-risk patients with the superiority of galectin-9 over CXCL-13. Although the two biomarkers were equal in prediction of TTT and treatment response, the soluble CXCL13 was superior in prediction of OS. High CXCL-13 and galectin-9 plasma levels upon CLL diagnosis are associated with disease activity, progression, advanced clinical stages, short periods of PFS, short TTT, and unfavorable treatment response.
摘要:
淋巴细胞白血病(CLL)的临床结果是非常不同的。这项观察性研究的目的是研究测量血浆半乳糖凝集素-9和CXCL-13浓度作为CLL活性预测因子的临床价值。预后,和治疗反应的早期指标。将这些生物标志物与其他预后指标进行比较,无进展生存期(PFS),首次治疗时间(TTT)和随访期(4年)的总生存期(OS)。首先,分析了CLL患者在诊断时的血浆半乳糖凝集素-9和CXCL-13浓度以及健康对照。与对照组相比,CLL患者的血清CXCL-13和半乳糖凝集素-9水平明显升高。第二,我们观察到具有高可溶性CXCL-13和半乳糖凝集素-9水平的CLL患者具有晚期临床分期,预后不良,17pdel,短PFS,短TTT,和治疗抵抗。CXCL-13,β2-微球蛋白,LDH,CD38%,Rai期的高等级均与半乳糖凝集素-9水平密切相关。可溶性CXCL-13和半乳糖凝集素-9在检测CLL疾病进展和高危患者方面具有很好的特异性和敏感性,半乳糖凝集素-9优于CXCL-13。尽管这两种生物标志物在预测TTT和治疗反应方面是相等的,可溶性CXCL13对OS的预测效果较好。CLL诊断后高CXCL-13和半乳糖凝集素-9血浆水平与疾病活动相关,programming,晚期临床阶段,短期PFS,短TTT,和不利的治疗反应。